Z Gastroenterol 2020; 58(01): e65
DOI: 10.1055/s-0039-3402281
Poster Visit Session V Viral Hepatitis and Immunology: Saturday, February 15, 2020, 11:00 am – 11:45 am, Lecture Hall P1
Georg Thieme Verlag KG Stuttgart · New York

Long-term course of a patient with overlap hepatitis C and IgG4-related cholangitis

S Christoph
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
,
K Willuweit
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
,
G Hilgard
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
,
G Gerken
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
,
H Wedemeyer
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
,
A Kahraman
1   University Hospital Essen, Department of Gastroenterology and Hepatology, Essen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2020 (online)

Also available at
 
 

    Background:

    Hepatitis C virus (HCV) causes not only liver disease that may progress to cirrhosis but also can induce extrahepatic manifestations in nearly 75% involving other organs. IgG4-associated autoimmune cholangitis (AIC) has gained attention as a biliary manifestation of IgG4-related sclerosing disease, characterized by elevated serum IgG4-levels and infiltrates with IgG4-positive plasma cells.

    Case report:

    A 85-year old female patient with histologically-proven IgG4-associated cholagitis and HCV-induced compensated liver cirrhosis (Child A, genotype 1b) was sucessfully treated with sofosbuvir (SOF) and ledipasvir (LED) for 12 weeks. HCV-RNA declined from a baseline viral load of 455'800 IU/ml below detection 4 weeks after treatment. SVR 24 was achieved in the follow-up visits. Interestingly, IgG4-levels significantly decreased by antiviral treatment from 12"750 mg/l to 5"728 mg/l within four months. Next, the patient will be sheduled for immunosuppressive treatment of AIC with steroids and azathioprine. Patient"s characteristics, lab results, course of both diseases, and treatment were documented from November 2014 to October 2019.

    Conclusions:

    Hepatitis C virus can induce several autoimmune disorders; in our case overlap to IgG4-related cholangitis was diagnosed. This is the first reported case of IgG4-related cholagitis improving by antiviral treatment.


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