A rapid favorable outcome after Sofosbuvir induced
leucocytoclasic vasculitis.
I Souilem, O Charfi, I Hamza, F Zgolli, S Kastalli, G Lakhoua and S El
Aidli.
National Center of Pharmacovigilance, 1006 Tunis, Tunisia; Research
unit: UR17ES12, Faculty of Medicine, University of Tunis El Manar, La
Rabta, 1007 Tunis, Tunisia.
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. Leucocytoclasic 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. 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 leucocytoclasic 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.
Keywords: Sofosbuvir, Hepatitis C, Leucocytoclastic vasculitis