Rapidly progressive HCV cirrhosis in a hypogammaglobulinemic patient.

Contrary to the widely known view of the insidious, slowly progressive pattern of hepatitis C, a rapidly progressive cirrhotic form can develop in immunodeficient conditions. Hepatitis C leads to cirrhosis in immunocompetent hosts after 20 years of infection however in hypogammaglobulinemic patients disease progresses faster, leading to cirrhosis and death within 10 years of diagnosis and frequently earlier. Here we present a 57-year-old woman with common variable immunodeficiency infected with hepatitis C after antral and duodenal resection and gastrojejunostomy operation in another hospital for lymphoma mimicking duodenal nodular hyperplasia which then rapidly progressed to decompensated cirrhosis in less than two years.

[1]  David H. Adams,et al.  Sleisenger and Fordtran’s Gastrointestinal and Liver Disease , 2007, Gut.

[2]  A. Salavati,et al.  Gastrointestinal Manifestations in Patients with Common Variable Immunodeficiency , 2007, Digestive Diseases and Sciences.

[3]  L. Uscanga,et al.  Clinical characteristics of a group of adults with nodular lymphoid hyperplasia: a single center experience. , 2006, World Journal of Gastroenterology.

[4]  A. Zullo,et al.  Duodenal Pathology and Clinical-Immunological Implications in Common Variable Immunodeficiency Patients , 2003, American Journal of Gastroenterology.

[5]  M. Ballow,et al.  Primary immunodeficiency disorders: antibody deficiency. , 2002, The Journal of allergy and clinical immunology.

[6]  Z. Goodman,et al.  Rates and risk factors of liver fibrosis progression in patients with chronic hepatitis c. , 2001, Journal of hepatology.

[7]  K. Smith,et al.  Common variable immunodeficiency treated with a recombinant human IgG, tumour necrosis factor‐α receptor fusion protein , 2001, The British journal of dermatology.

[8]  C. Cunningham-Rundles,et al.  Common variable immunodeficiency: clinical and immunological features of 248 patients. , 1999, Clinical immunology.

[9]  E. Torres,et al.  Sustained response to interferon in a patient with common variable immunodeficiency and hepatitis C. , 1997, American Journal of Gastroenterology.

[10]  A. Giovannetti,et al.  HCV infection in patients with primary defects of immunoglobulin production , 1995, Clinical and experimental immunology.

[11]  G. Luzi,et al.  Hepatitis C virus infection in hypogammaglobulinemic patients receiving long‐term replacement therapy with intravenous immunoglobulin , 1995, Transfusion.

[12]  S. Frøland,et al.  Hepatitis C infection in patients with primary hypogammaglobulinemia after treatment with contaminated immune globulin. , 1994, The New England journal of medicine.

[13]  J. Farrant,et al.  Failure in antigen responses by T ceils from patients with common variable immunodeficiency (CVID) , 1994, Clinical and experimental immunology.

[14]  J. Zeldis,et al.  Hepatitis C virus pathogenicity: the corner pieces of the jigsaw puzzle are found. , 1994, Gastroenterology.

[15]  J. D. de Vries,et al.  Peripheral blood lymphocytes of patients with common variable immunodeficiency (CVI) produce reduced levels of interleukin-4, interleukin-2 and interferon-gamma, but proliferate normally upon activation by mitogens. , 1989, Clinical and experimental immunology.

[16]  Charlotte Cunningham-Rundles,et al.  Incidence of cancer in 98 patients with common varied immunodeficiency , 1987, Journal of Clinical Immunology.

[17]  Beavan Te NEW LIGHT ON CARCINOID FLUSH. , 1964 .

[18]  A. Zullo,et al.  Duodenal pathology and clinical-immunological implications in common variable immunodeficiency patients. , 2003 .

[19]  H. Kishimoto,et al.  Common variable immunodeficiency with unusual vegetative lesions of the tongue and labial mucosa: a case report. , 2001, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[20]  C. Cunningham-Rundles,et al.  Intravenous immunoglobulin prophylaxis causing liver damage in 16 of 77 patients with hypogammaglobulinemia or IgG subclass deficiency. , 1988, The American journal of medicine.