A case of recurrent hepatitis C after liver transplantation associated with pulmonary tuberculosis and mediastinal tuberculous lymphadenitis

Abstract

A 50-year-old man underwent orthotopic liver transplantation in June 2006 for decompensated cirrhosis due to hepatitis C virus infection. In March 2007 he was diagnosed with recurrent hepatitis C and he was given interferon α2b and ribavirin. 17 months after interferon treatment, serum HCV-RNA was negative. At the same period, a CT scan of the chest showed multiple mediastinal lymphadenopathy, and a pale opacity in the left upper lobe. Thoracoscopic biopsy of mediastinal lymph node confirmed mediastinal tuberculous lymphadenitis. Then he was treated with combined therapy with 4 anti-tuberculous drugs (RFP, INH, EB, and PZA). Until now he has been given interferon α2b and ribavirin with anti-tuberculous therapy. Although mediastinal tuberculous lymphadenitis after liver transplantation is rare, we must recognize the disease as a complication after liver transplantation. © 2009 The Japan Society of Hepatology.