RESUMO
A serotype-1 hepatitis C virus (HCV) infection in a 67-year-old hemodialysis patient was treated using interferon (IFN)-beta. Although the patient had a high RNA titer (5.1 log IU/mL) and had been receiving long-term hemodialysis therapy (30 years), the initial 4-week IFN-beta administration enabled a rapid virological response without any major adverse effects. However, the final outcome after 24 weeks of IFN beta treatment was classified as unchanged based on the criteria of the Conference on Intractable Hepatitis. Here, we describe our experience treating HCV infection using IFN-beta and discuss the indications for such therapy.
Assuntos
Glomerulonefrite/terapia , Hepacivirus/genética , Hepatite C/tratamento farmacológico , Interferon beta/uso terapêutico , RNA Viral/sangue , Diálise Renal , Idoso , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Glomerulonefrite/sangue , Hepatite C/sangue , Humanos , Injeções Intravenosas , Interferon beta/administração & dosagem , Masculino , Resultado do TratamentoRESUMO
Differential diagnosis of focal nodular hyperplasia and hepatocellular carcinoma is clinically important because, while both are hypervascular tumors, they have vastly different prognoses. Because the spoke-wheel appearance is the primary characteristic of focal nodular hyperplasia, we attempted to detect this pattern in nodules smaller than 3 cm in diameter with contrast-enhanced ultrasonography using a contrast agent (Levovist). Four patients were examined with contrast-enhanced US: two of the patients were examined with Coded Harmonic Angio; the other two patients were examined with contrast-enhanced color and power Doppler US without harmonic imaging. Although the hepatic arteriogram showed the spoke-wheel appearance in only one tumor (diameter, 3 cm), contrast-enhanced US clearly demonstrated this characteristic in all four tumors, including three tumors that were less than 2 cm in diameter. Because it is noninvasive and can be carried out in an outpatient clinic, contrast-enhanced US is extremely useful for diagnosing small focal noduler hyperplasia lesions at sites that can be observed with US.