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, 3 (3), 218-21

Fatal Neutropenic Enterocolitis During Pegylated Interferon and Ribavirin Combination Therapy for Chronic Hepatitis C Virus Infection

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Fatal Neutropenic Enterocolitis During Pegylated Interferon and Ribavirin Combination Therapy for Chronic Hepatitis C Virus Infection

Ji Hun Kim et al. Gut Liver.

Abstract

It is known that neutropenia caused by combination pegylated interferon plus ribavirin therapy for hepatitis C virus (HCV) infection is well tolerated and carries a negligible risk of infection. Neutropenic enterocolitis is encountered most frequently in patients with hemato-oncologic diseases who are undergoing intensive chemotherapy. However, little information exists regarding this life-threatening event in the setting of HCV therapy. We present here an unusual case of fatal neutropenic enterocolitis in a cirrhotic patient receiving combination therapy for HCV infection. This is the first report of a death from neutropenic enterocolitis associated with treatment for chronic HCV infection. The present case suggests that caution should be exercised when continuing HCV therapy in neutropenic patients with advanced fibrosis, and the decision to maintain such therapy should be balanced against the potential for serious adverse events.

Keywords: Hepatitis C; Interferons; Neutropenic enterocolitis.

Figures

Fig. 1
Fig. 1
Ultrasonography of the liver showing (A) a coarse echotexture of the parenchyma, an irregular nodular surface, and (B) splenomegaly (approximately 13 cm).
Fig. 2
Fig. 2
Serial changes in the white blood cell count (WBC) and absolute neutrophil counts (ANCs) after pegylated interferon and ribavirin combination therapy.
Fig. 3
Fig. 3
CT scan on admission of a patient who presented with symptoms of neutropenic enterocolitis. (A) Edematous wall thickening of the ascending colon with pericolic strands. (B) Cirrhotic liver with minimal ascites in the perihepatic space, and splenomegaly.

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