Hepatitis C Virus–Related Hepatic Myelopathy After Treatment With Sofosbuvir and Ribavirin: A Case Report
Authors: Lazzaro di Biase, Marina Picillo, Maria Eliza Freitas, Esther Bui, Alfonso Fasano
Journal: Annals of Internal Medicine (2017)

Letters7 March 2017Hepatitis C Virus–Related Hepatic Myelopathy After Treatment With Sofosbuvir and Ribavirin: A Case ReportLazzaro di Biase, MD, Marina Picillo, MD, Maria Eliza Freitas, MD, Esther Bui, MD, and Alfonso Fasano, MD, PhDLazzaro di Biase, MDFrom Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Search for more papers by this author, Marina Picillo, MDFrom Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Search for more papers by this author, Maria Eliza Freitas, MDFrom Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Search for more papers by this author, Esther Bui, MDFrom Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Search for more papers by this author, and Alfonso Fasano, MD, PhDFrom Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0038 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Hepatic myelopathy is a rare complication of advanced-phase liver dysfunction (1). The most common presentation is spastic paraparesis, which is associated with variable sensory deficits (2). Hepatic myelopathy is a progressive, disabling condition that may reverse if normal liver function is restored—for example, after transplantation (Appendix Table) (2). Sofosbuvir is a novel nucleotide analogue that inhibits the NS5B polymerase of hepatitis C virus (HCV). Sofosbuvir produces a high rate of sustained virologic response when used to treat HCV infection (3).Appendix Table. Outcome of Reported Patients With Hepatic Myelopathy Objective: ...References1. Liversedge LA, Rawson MD. Myelopathy in hepatic disease and portosystemic venous anastomosis. Lancet. 1966;1:277-9. [PMID: 4158891] CrossrefMedlineGoogle Scholar2. Caldwell C, Werdiger N, Jakab S, Schilsky M, Arvelakis A, Kulkarni S, et al. Use of model for end-stage liver disease exception points for early liver transplantation and successful reversal of hepatic myelopathy with a review of the literature. 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[PMID: 21031552] doi:10.1002/lt.22149 CrossrefMedlineGoogle Scholar20. Premkumar M, Bagchi A, Kapoor N, Gupta A, Maurya G, Vatsya S, et al. Hepatic myelopathy in a patient with decompensated alcoholic cirrhosis and portal colopathy. Case Reports Hepatol. 2012;2012:735906. [PMID: 25374709] doi:10.1155/2012/735906 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Campus Bio-Medico University of Rome, Rome, Italy; University of Salerno, Salerno, Italy; and Toronto Western Hospital and University Health Network, and University of Toronto, Toronto, Ontario, Canada.Grant Support: Dr. Freitas is supported by the Paul and Susan Hansen Clinical Fellowship Award. Dr. Fasano is supported by grants from the University of Toronto, McLaughlin Centre, and Michael J. Fox Foundation.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0038. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySpontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis: A case reportLiver Transplantation Reverses Hepatic Myelopathy in Hepatitis B-Related Decompensated Liver Cirrhosis: Case Report and Review of the LiteratureMetabolic and Toxic MyelopathiesThe effect of fecal microbiota transplantation on Hepatic myelopathyMotor Cortex Mapping in Patients With Hepatic Myelopathy After Transjugular Intrahepatic Portosystemic Shunt 7 March 2017Volume 166, Issue 5Page: 379-380KeywordsBrain diseasesDisclosureHematologic testsLiver transplantationMyelopathyProteinsSpineTransplantationViral loadWheelchairs ePublished: 7 March 2017 Issue Published: 7 March 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...