A rapid favorable outcome after sofosbuvir induced leucocytoclastic
vasculitis.
Abstract
Background: Sofosbuvir, a very effective new direct-acting antiviral
agent (DAA), has revolutionized the therapeutic management of people
infected with hepatitis C virus. It has a low reported rate of side
effects. Leukocytoclastic vasculitis can be associated with hepatitis C
but can also be induced by many drugs. We describe a case of
leucocytoclasic vasculitis induced by Sofosbuvir that resolved 3 days
after drug withdrawal. We observed a temporal relationship between the
treatment and the onset of vasculitis. We emphasize the
multidisciplinary approach to patients with hepatitis C to make the
difference between drug-induced skin damage and damage caused by the
virus itself. Case presentation: A 61-year-old woman, with a history of
hepatitis C virus infection started treatment with the combination
ledipasvir sofosbuvir in June 2020, 400 mg per day. Five weeks later,
she developed a slightly itchy erythematous and symmetrical rash on
lower members. The patient initially suspected the treatment and she
stopped it. Histological finding revealed a diffuse neutrophile
infiltration of vessel walls confirming leukocytoclastic vasculitis.
These lesions disappeared completely three days after drug withdrawal
without any symptomatic treatment. Conclusions: Sofosbuvir is one of the
several recent drugs that should be prone to further attention.