Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Case report
A case of overwhelming postsplenectomy infection (OPSI) with chronic hepatitis type C during peginterferon/ribavirin combination therapy
Shusuke OKAMURATerufumi SAKAIHiroshi YOSHIKAIHiroaki SUMIEKozaburou NARITATaku KARASHIMAYasuhiko MAEYAMAKoichi HIGAKITatsuya IDEMichio SATA
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2009 Volume 106 Issue 3 Pages 411-417

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Abstract

A 61-year-old woman with a past history of splenectomy was admitted to our hospital because of high fever and loss of consciousness during interferon therapy for the treatment of chronic hepatitis type C. She died of multiple organ failure, and disseminated intravascular coagulation shortly after admission. The results of blood culture and the autopsy revealed sepsis due to streptcoccus pneumonia. The neutropenia and immunosuppression by interferon therapy induced overwhelming postsplenectomy infection (OPSI), a potentially rapidly fatal septicemia. When we perform treatment with immunosuppression such as interferon therapy or anticancer drug therapy to splenectomised patients, it is necessary to carry out pnemococcus vaccination. Splenectomy is performed for patients with thrombocytopenia of chronic hepatitis type C before interferon therapy. To avoid OPSI, partial splenic arterial embolization was discussed.

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© 2009 by The Japanese Society of Gastroenterology
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