HCV & ITP

My daughter was treated in 1999 with 48 weeks of combination Interferon & Ribavirin.  She did clear the virus and has had negative RNA since.  In June, 2008 she developed ITP which is Immune Thormbocytopenia.  It is an auto-immune disorder where her body is destroying its platelets.  I know there can be a relationship between Hep C & ITP, but her doctor didn't think there would be a connection almost 9 years after treatment.

Gay Ketterer  

[HCA]

I don't know for sure,but I would be surprised if there is a connection between the anti-viral treatment and the ITP.
People do tend to blame all or any subsequent adverse events on ant-viral thereapy,or at least make the interferon the number one suspect.
Platelet deficiency is common in advanced chronic Hep C due to an enlarged spleen,and also as a contemporanous side effect to interferon.
A delayed auto-immune response may be possible but without evidence I would guess the two events are unconnected.

[kittyface]

I'm no doctor, but isn't there a possibility that the tx triggered a reaction that gradually took 9 years to manifest itself?  Or possibly the daughter has an enlarged spleen?  I was on tx for 48 months and wouldn't be surprised if I grew horns from those potent meds.

I don't know how common ITP is but I don't think it's that prevalent and if she took treatment I would be very suspect.  Unfortunately, figuring out what caused it probably can't provide a remedy unless the culprit is something she's currently exposed to.

Gay, I hope your daughter recovers and is able to lead a happy, functional life.

Best regards,

Kittyface

[Kathy73]

Is the diagnosing doctor a hematologist or a GP? I was diagnosed with ITP around 5 years ago and with HEP C last year. I had to get INVG in order to get my platelets up enough to get a liver biopsy. Surprisingly on tx for Hep C my platelets have increased. Since diagnosis of ITP is by exclusion, has your daughter gotten a bone marrow biopsy and other tests done for this diagnosis?

[GayK]

She has been tested for everything.  They call it ideopathic as the cause can not be determined.  She has not yet had a bone marrow biopsy as they can tell by the size of the platelets that her bone marrow is producing new platelets.  It is tough because I want to be sure any of the treatments for ITP are gentle to the liver.

Gay K

[Bulldoggergal]

Isn't ITP Idiopathic Thrombocytopenic Purpura?  I say that because I have TTP, a more rare form of it where my body also destroys the Red Blood Cells.

She needs to see a Hematologist about this condition and its treatment options.  The doc will probably be able to tell you if it could have been from the treatment...more likely it was actually from the HepC itself...has she been retested for the HCV recently?  There are many causes of ITP...it's not so rare...but it isn't fun either!!  

[Kathy73]

My hematologist is working with my hepatologist and my GP. I think it would be beneficial if  you had all of your specialists working together to make this treatment happen. If her platelets diminish it will be her hematologist who helps.

[GayK]

She was treatede for the Hep C in 1999 with 48 weks of interferon & ribaviran.  She has been negative since.  The ITP is being treated by a hemotologist.  I have checked both with the hemotologist and the pediatric hepatologist/gastroenterologist who was in charge of her Hep C treatment.  Neither feels that the ITP is a result of the Hep C or treatment, especially since it was almost 10 years ago.  But, no one can be sure.  I was just trying to check out to see if other with Hep C or similar treatment has subsequent problems with ITP.  Sometimes it is call Ideopathic Thrombocycopenia Purpura and sometimes Immune Thrombocycopenia.  She has never had much purpura, bruising or petechiae.

Gay K  

[Kathy73]

I wish I could say the same. Sometimes I was covered in deep purple huge bruising. Not so much for the past 4 months on treatment. I've heard that there is a new medication to raise platletes but I don't know the name.

Good luck!

[CanaryParker]

The drug you may be referring to is called Eltromboag and if that is it, it's still in trials.

I have low platelets but only since tx. Thye have increased by and still low but as of now slowly increasing.
The platelets originally were enlarged..something they will do if not enough and not being produced well.
The doctors do feel that the tx is what did it as spleen, liver,.. are doing well.
They would like to do a bone marrow biopsy :(
The platelets are also sticky so no bleeds or bruising so far...but upon last mri, ultrasound and ct with dye contrast, a clot was found. everything was normal. ?
ITP is prevalent enough for forums on that topic and docs are not unfamiliar of that condition.
GayK...I bruised on tx.

[Kathy73]

I had the bone marrow biopsy. Just before the doctor inserted a HUGE needle into my hip he told me: Either you won't feel anything except pressure or you will be in the worst pain of your life. Luckily I just felt the pressure! Just a heads-up...

[Bulldoggergal]

Yep, the bone marrow test was NOT fun!  Here is an article on ITP and HCV to check out...doesn't everyone diagnosed w/ITP or TTP has to have this test to confirm the body is even producing the platelets...it was the first thing they did when my platelets began to crash...before the TTP diagnosis.

This is a good article....

http://www.hcvadvocate.org/news/NewsUpdates_pdf/Advocate%202009/advocate0409.pdf