Severe mixed thrombocytopenia in a women treated with interferon for chronic hepatitis C

BACKGROUND: Thrombocytopenia occurred in a woman given alpha interferon for chronic hepatitis C without cirrhosis. Both central thrombocytopenia, clea rly demonstrated, and peripheral thrombocytopenia, probably of autoimmune o rigin, were involved. CASE REPORT: A 55-year-old woman with active chronic hepatitis C (Metavir s core A2, F2) was given alpha interferon. One month after treatment onset, s he developed thrombocytopenia (32 G/L). A second bone marrow aspirate and o steomedullary biopsy evidenced megalokaryocytes and the platelet count resp onded to polyvalent immunoglobulins. Five months after discontinuing interf eron, the platelet count progressively returned to normal. DISCUSSION: Central thrombocytopenia is classically described in patients g iven interferon and usually appears during the first weeks of treatment In our case, the central mechanism was clearly demonstrated by the bone marrow aspirate and osteomedullary biopsy findings at a time when the platelet co unt was 32 G/L. A peripheral immunological participation was more difficult to prove but was strongly suggested by the persistence of thrombocytopenia despite the interruption of the interferon and the efficacy of immunoglobu lins.