Dermatomyositis associated with hepatocellular carcinoma in an elderly female patient with hepatitis C virus-related liver cirrhosis

Toshikuni, Nobuyuki; Torigoe, Rikako; Mitsunaga, Mikio; Omoto, Akiyoshi; Nakashima, Kenji

doi:10.3748/wjg.v12.i10.1641

Cited by 25 publications

(17 citation statements)

References 17 publications

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“…In literature, we can find this association in a case series of five patients by Fiore et al in 1996,5 and in isolated cases reported by Gomez et al in 1997,6 Kee et al in 20047 and Toshikuni et al in 2006 8. In most of the cases of dermatomyositis, the diagnosis of HCV infection was incidental and not always coincident in time.…”

Section: Discussionmentioning

confidence: 80%

Hepatitis C virus infection: ‘beyond the liver’

Castro¹,

Vilas

Borges‐Costa

et al. 2018

BMJ Case Reports

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There are rare reports of association between hepatitis C virus (HCV) infection and dermatomyositis although cause and effect remains to be proven. We present a clinical case with a probable cause and effect association between these two entities. A 71-year-old woman developed an erythematous exanthem with pruritic and scaly lesions located at the torso and upper limbs associated with heliotrope and Gottron's papules. At the same time, she notice a significant loss of muscular strength. Skin and muscular biopsies made the diagnosis of dermatomyositis and the patient started with prednisolone (60 mg/day) with poor symptoms control. Paraneoplastic syndrome, HIV, hepatitis B virus and syphilis infections were excluded. HCV serology was positive, with a viral load of 58 159 IU/mL (genotype 1a). Therefore, the patient underwent a 12-week treatment with grazoprevir 100 mg and elbasvir 50 mg achieving a sustained virological response with regression of skin lesions and complete recovery of muscular strength (photodocumented before/after treatment). Additionally it was possible to reduce prednisolone dosage to 5 mg/day.

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Section: Discussionmentioning

confidence: 80%

Hepatitis C virus infection: ‘beyond the liver’

Castro¹,

Vilas

Borges‐Costa

et al. 2018

BMJ Case Reports

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“…99,100 Also, transcatheter arterial embolization of HCC did not affect the course of DM. 96 In contrast, a paraneoplastic hypothesis gains limited credence from a single report of a patient with DM who improved without steroid treatment after resection of HBVassociated HCC. 97…”

Section: Dermatomyositismentioning

confidence: 93%

“…Patients died for reasons unrelated to myopathy. 93,94,96 It was not possible to unequivocably determine whether the autoimmune response underlying DM was triggered by the HCV infection or a paraneoplastic phenomenon. Virus-induced autoimmunity seems more likely because HCC-related DM in adults has occurred only in the context of HCV or hepatitis B virus 97,98 infections; in two cases, the viral state was not investigated/recorded.…”

Section: Dermatomyositismentioning

confidence: 98%

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Neuromuscular Diseases Associated With Chronic Hepatitis C Virus Infection

Stübgen

2011

Journal of Clinical Neuromuscular Disease

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Hepatitis C virus (HCV) infection is a growing international health problem, and more than 170 million people are chronic carriers. Up to 50% of HCV-positive patients develop at least one extrahepatic manifestation during the course of disease. To varying degrees of certainty, there is evidence of an association between chronic HCV infection and a variety of neuromuscular diseases. The pathogenesis of most extrahepatic diseases remains unclear but possibly includes HCV lymphotropism and/or HCV-induced autoantibodies. The therapeutic approach to HCV-associated autoimmune disorders entails eradication of HCV with one of the recombinant interferon-alpha preparations with or without additional immunosuppressive drugs.

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“…Dermatomyositis has also been reported in a hepatitis C patient with hepatocellular carcinoma. 84 Cancer risk is highest within the first year of being diagnosed with either of the two inflammatory myopathies. 83 As muscle symptoms often precede the diagnosis of malignancy, 19 continued cancer surveillance is important.…”

Section: Malignancymentioning

confidence: 99%

Myopathic Complications of Medical Disease

Soni¹,

Amato²

2009

Semin Neurol

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Disorders of muscle may be primary or acquired secondary to an underlying medical condition. Clinical presentations range from asymptomatic elevations in creatine kinase to fatal rhabdomyolysis. Recognition of the underlying precipitant is imperative to effectively institute treatment for a potentially reversible process. The focus of this article is to review complications of systemic illness that result in signs and symptoms of muscle dysfunction. Myopathic complications of endocrinopathy, metabolic abnormalities, medications, critical illness, organ transplantation, infection, autoimmune conditions, malignancy, and toxin exposure are discussed, with an emphasis on the clinical features, electromyography, and muscle biopsy findings.

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Dermatomyositis associated with hepatocellular carcinoma in an elderly female patient with hepatitis C virus-related liver cirrhosis

Cited by 25 publications

References 17 publications

Hepatitis C virus infection: ‘beyond the liver’

Hepatitis C virus infection: ‘beyond the liver’

Neuromuscular Diseases Associated With Chronic Hepatitis C Virus Infection

Myopathic Complications of Medical Disease

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