Pituitary Disease in Chronic Hepatitis C Infection and Interferon-alpha Related Therapy: Two Case Reports

Abstract

Pituitary dysfunction in chronic hepatitis C infection treated with interferon-alpha is a rare condition with 4 case reports world wide. We hereby report two cases of pituitary dysfunction in HCV patients, with and without interferon-alphatherapy. Case 1: A 34-year-old man co-infected with HIV and HCV presented with a 3 month history of lethargy, listlessness and a general lack of energy. Past medical histories include inactive neurosyphillis, chronic schizophrenia and seizure. His HCV is genotype 1 without cirrhosis and he completed a 48-week course of combination IFN-alpha and RBV for 48 weeks uneventfully 3 months prior. Examination and investigation found him to isolated ACTH deficiency. His condition improved markedly with corticosteroid replacement therapy. Case 2: A 45 year-old and treatment naive man with chronic HCV infection presented with a 20 kg weight loss, lack of energy and the occasional dizziness. Examination and investigation found him to have panhypopituitarism. Replacement therapy was initiated including hydrocortisone, testosterone and hydrocortisone. He made a slow but steady recovery and regained about 15 kg of weight but unfortunately was lost to follow up. It concluded that hepatitis C infection on its own or in conjunction with interferon-alpha based therapy can result in pituitary failure. The condition is readily treatable and hence should be considered in the appropriate clinical setting.




J Endocrinol Metab. 2012;2(4-5):190-194
doi: https://doi.org/10.4021/jem117w