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A case of exacerbation of ulcerative colitis induced by combination therapy with PEG-interferon -2b and ribavirin

¹ Department of Internal Medicine, Medical Hospital, The Nippon Dental University, Niigata, Niigata, Japan
² Department of Gastroenterology, Japan Labour Health and Welfare Organization, Tsubame Rosai Hospital, Tsubame, Niigata, Japan
³ Department of Internal Medicine, Medical Hospital, The Nippon Dental University, Niigata, Niigata, Japan

Correspondence to:
Correspondence to:
Dr T Watanabe
Department of Internal Medicine, Medical Hospital, The Nippon Dental University, Hamauracho 1-8, Niigata, Niigata, Japan; nabetaku@dia-net.ne.jp

Keywords: adverse reactions; chronic hepatitis C; PEG interferon; ribavirin; ulcerative colitis

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A 55 year old man with chronic hepatitis C presented with diarrhoea and bloody stools in July 2003. Colonoscopic examination showed redness and oedematous mucosa in the rectum and ulcerative colitis was suspected. Biopsy of the lesion confirmed the diagnosis and treatment was initiated with mesalazine (5-ASA 2250 mg/day). However, he showed short term improvement and mesalazine was discontinued. He was treated with percutaneous radiofrequency ablation therapy (RFA)(Cool-tip) for adenomatous hyperplasia in S5 of the liver in December 2004. After providing consent to treatment with interferon (IFN), the patient underwent combination therapy with PEG-IFN-2b (100 mg/week) and ribavirin (800 mg/day) for chronic hepatitis C. Liver biopsy and blood biochemistry revealed chronic active hepatitis C virus (HCV) F3/A2, genotype 1b, liver injury associated with HCV, aspartate aminotransferase (AST) 109 IU/l, alanine aminotransferase (ALT) 126 IU/l, and HCV RNA 3400.0 KIU/ml (by reverse transcription nested polymerase chain reaction, high range method).

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