C型慢性肝炎に対するdaa治療中に発症した潰瘍性大腸炎の1例

We report the case of a man in his thirties with chronic hepatitis C who was treated with a direct-acting antiviral (DAA); Glecaprevir / Pibrentasvir combination tablet. After five weeks, he had diarrhea three to four times per day, and after seven weeks, he had 10 episodes of bloody and watery diarrhea per day with a fever of 38°C. Colonoscopy revealed erythema, loss of normal vascular pattern, erosions, friability, bleeding, purulent exudate and ulcerations without skip areas. Histopathologic findings revealed marked increase of inflammatory cell infiltration, Goblet cell depletion, mucosal distortion, cryptitis and crypt abscess. The diagnosis was ulcerative colitis. Although he had been treated with oral 5-aminosalicylic acid drugs, symptoms deteriorated; therefore, steroid therapy was started in hospital. The steroid therapy was effective; thereafter, outpatient treatment was continued. After six months, colonoscopy revealed inflammatory improvement. He had been treated with oral 5-aminosalicylic acid drugs and maintained state of remission. Furthermore, DAA therapy led to a sustained virological response.