Abstract
BackgroundHepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP). While its incidence has been largely described during chronic HCV infection, only one case of ITP secondary to acute HCV infection has been reported at this time.Case presentationWe report herein the case of severe ITP secondary to an acute HCV genotype 1a reinfection in a human immunodeficiency virus (HIV)-negative man having sex with men who had been cured several years before of a previous acute genotype 4d HCV infection. After an unsuccessful standard therapy with two courses of intravenous immunoglobulin (at 1 g/kg daily for 2 days) associated with methylprednisolone 1 mg/kg daily, antiviral treatment with sofosbuvir-ledipasvir rapidly achieved virological response and normalised the platelet count.ConclusionsAs a direct effect of HCV on megakaryocytes could be the predominant cause of ITP during acute infection, early antiviral treatment may be beneficial in this case.
Highlights
Hepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP)
As a direct effect of HCV on megakaryocytes could be the predominant cause of ITP during acute infection, early antiviral treatment may be beneficial in this case
Immune thrombocytopenia (ITP) is an acquired thrombocytopenia caused by immune platelet destruction
Summary
Hepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP). Conclusions: As a direct effect of HCV on megakaryocytes could be the predominant cause of ITP during acute infection, early antiviral treatment may be beneficial in this case. Hepatitis C virus (HCV) infection is a recognised cause of secondary ITP [3]. Its occurrence has been well described in the case of chronic infection where the diagnosis can be difficult as different factors can contribute to thrombocytopenia including cross-reactive antibodies
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