Chronic Hepatitis C Therapy in Liver Cirrhosis Complicated by Telaprevir-Induced DRESS
Joint Authors
Egwim, Chukwuma I.
Mousa, Omar Y. S.
Zela, Scott A.
Shannon, Rhonda L.
Khalaf, Rossa
Ankoma-Sey, Victor
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-08-20
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare yet severe adverse drug-induced reaction with up to 10% mortality rate.
Recent clinical trials reported an association between DRESS and telaprevir (TVR), an NS3/4A protease inhibitor of chronic hepatitis C (CHC) virus genotype 1.
Its diagnosis is challenging given the variable pattern of cutaneous eruption and the myriad internal organ involvement.
We present two patients who are middle-aged, obese, and white with CHC cirrhosis.
They both developed a progressive diffuse, painful pruritic maculopapular rash at weeks 8 and 10 of CHC therapy with TVR, Peg-Interferon alfa-2a, and Ribavirin.
They had no exposures to other medications that can cause this syndrome.
Physical exam and labs and skin biopsy supported a “Definite” clinical diagnosis of DRESS, per RegiSCAR criteria.
Thus Telaprevir-based triple therapy was discontinued and both patients experienced rapid resolution of the systemic symptoms with gradual improvement of eosinophilia and the skin eruption.
These two cases illustrate the paramount importance of having a high index of suspicion for TVR-induced DRESS, critical for early diagnosis.
Immediate discontinuation of TVR is essential in prevention of a potentially life-threatening complication.
Risk factors for development of DRESS in patients receiving TVR remain to be elucidated.
American Psychological Association (APA)
Mousa, Omar Y. S.& Khalaf, Rossa& Shannon, Rhonda L.& Egwim, Chukwuma I.& Zela, Scott A.& Ankoma-Sey, Victor. 2014. Chronic Hepatitis C Therapy in Liver Cirrhosis Complicated by Telaprevir-Induced DRESS. Case Reports in Medicine،Vol. 2014, no. 2014, pp.1-6.
https://search.emarefa.net/detail/BIM-467484
Modern Language Association (MLA)
Mousa, Omar Y. S.…[et al.]. Chronic Hepatitis C Therapy in Liver Cirrhosis Complicated by Telaprevir-Induced DRESS. Case Reports in Medicine No. 2014 (2014), pp.1-6.
https://search.emarefa.net/detail/BIM-467484
American Medical Association (AMA)
Mousa, Omar Y. S.& Khalaf, Rossa& Shannon, Rhonda L.& Egwim, Chukwuma I.& Zela, Scott A.& Ankoma-Sey, Victor. Chronic Hepatitis C Therapy in Liver Cirrhosis Complicated by Telaprevir-Induced DRESS. Case Reports in Medicine. 2014. Vol. 2014, no. 2014, pp.1-6.
https://search.emarefa.net/detail/BIM-467484
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-467484