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Clinical Journal of Gastroenterology
Published in: Clinical Journal of Gastroenterology 5/2017

01-10-2017 | Case Report

Disappearance of multiple hyperechoic liver nodules in sporadic porphyria cutanea tarda after treatment with ledipasvir/sofosbuvir for hepatitis C

Authors: Kazuhide Takata, Satoshi Shakado, Keiko Sakamoto, Hiromi Fukuda, Ryo Yamauchi, Sho Fukuda, Hideo Kunimoto, Kaoru Umeda, Takashi Tanaka, Keiji Yokoyama, Daisuke Morihara, Yasuaki Takeyama, Makoto Irie, Shotaro Sakisaka

Published in: Clinical Journal of Gastroenterology | Issue 5/2017

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Abstract

Ultrasonography in a 60-year-old man with chronic hepatitis C (CHC) demonstrated multiple hyperechoic nodules. Radiological investigations did not reveal any signs of malignancy. However, magnetic resonance chemical shift imaging showed multiple focal fatty changes in the liver. Urinary levels of uroporphyrin and coproporphyrin were elevated, and we made a diagnosis of porphyria cutanea tarda. Direct-acting antivirals, ledipasvir/sofosbuvir, were initiated for CHC, which led to sustained viral response, resolution of the liver nodules, and normalization of urinary porphyrin. Hepatitis C virus infection can cause porphyria cutanea tarda with multiple hyperechoic liver nodules, which might be cured by direct-acting antivirals.
Literature
1.
Chuang TY, Brashear R, Lewis C. Porphyria cutanea tarda and hepatitis C virus: a case-control study and meta-analysis of the literature. J Am Acad Dermatol. 1999;41:31–6.CrossRefPubMed
2.
Dabrowska E, Jablonska-Kaszewska I, Bielawski KP, et al. Influence of hepatitis C virus (HCV) infection on porphyrin and iron metabolism in porphyria cutanea tarda (PCT) patients. Med Sci Monit. 2001;7:190–6.PubMed
3.
Gisbert JP, Garcia-Buey L, Pajares JM, et al. Prevalence of hepatitis C virus infection in porphyria cutanea tarda: systematic review and meta-analysis. J Hepatol. 2003;39:620–7.CrossRefPubMed
4.
Fargion S, Piperno A, Cappellini MD, et al. Hepatitis C virus and porphyria cutanea tarda: evidence of a strong association. Hepatology. 1992;16:1322–6.CrossRefPubMed
5.
6.
Kersjes W, Harder T, Steudel A, et al. Multiple circular liver foci in latent porphyria cutanea tarda. RoFo. 1988;148:165–8 (in German).CrossRefPubMed
7.
Lelbach WK, Muller TR, Kersjes W, et al. Multiple nodular foci in the liver associated with chronic hepatic porphyria after previous treatment of breast cancer. Klin Wochenschr. 1989;67:592–7.CrossRefPubMed
8.
Kawamoto C, Ido K, Hitomi N, et al. A case of porphyria cutanea tarda with multiple hyperechoic lesions in the liver. Kanzo. 1989;30:241–6 (in Japanese).CrossRef
9.
Komatsu M, Goto M, Ishida S, et al. Three cases of chronic hepatic porphyria demonstrateing the image similar to focal fatty change in the liver. J Jpn Soc Gastroenterol. 1990;87:2669–74 (in Japanese).
10.
Flueckiger F, Steiner H, Leitinger G, et al. Nodular focal fatty infiltration of the liver in acquired porphyria cutanea tarda. Gastrointest Radiol. 1991;16:237–9.CrossRefPubMed
11.
Miyachi H, Kubota M, Fusegawa H, et al. Focal fatty infiltration in chronic hepatic porphyria without skin lesion. Jpn J Med Ultrasonics. 1995;22:147–51 (in Japanese).
12.
Chevallier P, Bahadoran P, Buckley MJ, et al. Hepatic multi-nodular focal fatty metamorphosis in acquired porphyria cutanea tarda. Sonographic, CT, and MRI features. Clin Imaging. 1998;22:418–21.CrossRefPubMed
13.
Dohmen K, Onohara S, Ajibe H, et al. Chronic hepatitis C associated with porphyria cutanea tarda which showed hepatic focal fatty change arising in a non-alcoholic patient. Kanzo. 1999;40:350–4 (in Japanese).CrossRef
14.
Saito A, Suto S, Tsuruta Y, et al. A case of multiple focal fatty change with porphyria cutanea tarda in chronic hepatitis C: improvement after interferon and ribavirin combination therapy. Kanzo. 2004;45:261–7 (in Japanese).CrossRef
15.
Nishiyama M, Sakamoto K, Shinagawa Y, et al. A case of porphyria cutanea tarda of the liver exhibiting multifocal macrovesicular steatosis in the background of microvesicular steatosis, probably caused by uneven iron accumulation. Abdom Radiol. 2017. doi:10.​1007/​s0026101710560.
16.
O’Reilly FM, Darby C, Fogarty J, et al. Porphyrin metabolism in hepatitis C infection. Photodermatol Photoimmunol Photomed. 1996;12:31–3.CrossRefPubMed
17.
Hussain I, Hepburn NC, Jones A, et al. The association of hepatitis C viral infection with porphyria cutanea tarda in the Lothian region of Scotland. Clin Exp Dermatol. 1996;21:283–5.CrossRefPubMed
18.
Chan OT, Tsai N, Wong RL, et al. The additive effects of hepatitis C infection and end-stage renal disease in porphyria cutaneatarda. Cutis. 2006;78:397–400.PubMed
19.
Jalil S, Grady JJ, Lee C, Anderson KE. Associations among behavior-related susceptibility factors in porphyria cutanea tarda. Clin Gastroenterol Hepatol. 2010;8:297–302.CrossRefPubMed
20.
Okano J, Horie Y, Kawasaki H, et al. Interferon treatment of porphyria cutanea tarda associated with chronic hepatitis type C. Hepatogastroenterology. 1997;44:525–8.PubMed
21.
Takikawa H, Yamazaki R, Shoji S, et al. Normalization of urinary porphyrin level and disappearance of skin lesions after successful interferon therapy in a case of chronic hepatitis C complicated with porphyria cutanea tarda. J Hepatol. 1995;22:249–50.CrossRefPubMed
22.
Aguilera P, Laguno M, To-Figueras J. Treatment of chronic hepatitis with boceprevir leads to remission of porphyria cutanea tarda. Br J Dermatol. 2014;171:1595–6.CrossRefPubMed
23.
Tong Y, Song YK, Tyring S. Resolution of porphyria cutanea tarda in patients with hepatitis C following ledipasvir–sofosbuvir combination therapy. JAMA Dermatol. 2016;152:1393–5.CrossRefPubMed
24.
Hatch MM, Nawas Z, Kollipara R, et al. Can curative antivirals benefit porphyria cutanea tarda in hepatitis C patients? J Eur Acad Dermatol Venereol. 2017. doi:10.​1111/​jdv.​13936.PubMed
25.
Combalia A, To-Figueras J, Laguno M, et al. Direct-acting antivirals for hepatitis C virus induce a rapid clinical and biochemical remission of porphyria cutanea tarda. Br J Dermatol. 2017. doi:10.​1111/​bjd.​15502.
26.
Wiznia LE, Laird ME, Franks AG Jr. Hepatitis C virus and its cutaneous manifestations: treatment in the direct-acting antiviral era. J Eur Acad Dermatol Venereol. 2017. doi:10.​1111/​jdv.​14186.PubMed
Metadata
Title
Disappearance of multiple hyperechoic liver nodules in sporadic porphyria cutanea tarda after treatment with ledipasvir/sofosbuvir for hepatitis C
Authors
Kazuhide Takata
Satoshi Shakado
Keiko Sakamoto
Hiromi Fukuda
Ryo Yamauchi
Sho Fukuda
Hideo Kunimoto
Kaoru Umeda
Takashi Tanaka
Keiji Yokoyama
Daisuke Morihara
Yasuaki Takeyama
Makoto Irie
Shotaro Sakisaka
Publication date
01-10-2017
Publisher
Springer Japan
Published in
Clinical Journal of Gastroenterology / Issue 5/2017
Print ISSN: 1865-7257
Electronic ISSN: 1865-7265
DOI
https://doi.org/10.1007/s12328-017-0772-x

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