Treatment of immune thrombocytopenia as an extra hepatic manifestation in an HCV-carrier man with normal liver function test- A case report

Rationale: The authors report a case of immune thrombocytopenia (ITP) as an extra hepatic manifestation in a hepatitis C virus (HCV)-carrier man with normal liver function tests. Presenting concern: A 42 year old male visited Dr. Prabhakar Kore Hospital on 21/6/15 in the medicine OPD. He had complaints of Fever for two days and rashes on both the forearms and also complaints of passing black colored stools. Diagnosis: The physical and laboratory examinations showed results within normal range except for very Low platelet counts and positive for HCV antibody (third generation).These findings suggested chronic infection with HCV, but there seemed to be no involvement of liver disease. Intervention: Patient was admitted and treatment was primarily aimed at improving platelet counts. Anti-viral therapy was prescribed. Interferon (IFN) and ribavirin to render HCV-PCR copies negative. Outcome: After 9 days of inpatient treatment the platelet counts were normalized and the patient discharged. Lesson learnt from this case: There are numerous papers reporting that HCV causes ITP as an extrahepatic manifestation, but a case report of ITP caused by chronic HCV infection without liver disease has not been found. The present case report discusses the specificity of HCV infection on extrahepatic manifestation, and the treatment of ITP caused by chronic HCV infection.