RESUMEN
Hepatitis C is an inflammatory disease of the liver caused by a single-stranded RNA virus belonging to the Hepacivirus genus in the Flaviviridae family, called the hepatitis C virus. After initial infection, 70% to 85% of the patients develop chronic hepatitis C with hepatic fibrosis. In addition to specific liver changes, various extrahepatic manifestations have been associated with the hepatitis C virus infection or with medications used to treat the condition. We report the case of a patient with chronic hepatitis C who presented with the signs and symptoms of borderline tuberculoid leprosy and type 1 reaction four months after the start of treatment with a pegylated interferon/ribavirin combination.
A hepatite C é uma doença inflamatória fígado causada por um vírus RNA de fita simples, pertencente ao gênero Hepacivirus e à família Flaviviridae, denominado de vírus da hepatite C. Após infecção inicial 70 a 85% dos pacientes infectados evoluem para hepatite C crônica, com fibrose progressiva. Além das alterações hepáticas específicas, várias manifestações extra-hepáticas têm sido relacionadas à infecção pelo vírus da hepatite C ou às medicações utilizadas no seu tratamento. Nesse trabalho, apresenta-se caso de paciente portador de hepatite C crônica, que manifestou um quadro hanseníase boderline tuberculóide e reação hansênica do tipo I, quatro meses após início do tratamento com interferon peguilado associado à ribavirina.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Antivirales/efectos adversos , Hepatitis C/tratamiento farmacológico , Interferones/efectos adversos , Lepra Dimorfa/inducido químicamente , Lepra Tuberculoide/inducido químicamente , Ribavirina/efectos adversos , Reacción de Fase Aguda/inducido químicamente , Quimioterapia Combinada/efectos adversos , Hepatitis C/complicaciones , Lepra Dimorfa/patología , Lepra Tuberculoide/patologíaRESUMEN
1. The liver is the main organ clearing both plasma and tissue kallikereins from the circulation. Hepatocytes are responsible for the internalization of rat plasma kallikrein (RPK) and liver cell is located on its heavy chain which is not exposed on prokallikrein. An S-type lectin accounts for the receptor-mediated endocytosis of TPK. 2. These properties of the liver are affected by pathological situations, particularly the acute-phase response to inflammation, in which the kallikrein-kinin system plays a major role. The hepatic clearance of the alfa2-macroglobulin-plasma kallikrein complex is less efficient than the clearance of the free enzyme