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