Hiroki IWATA¹, Masafumi HASHIGUCHI^{1, 2}, Tsutomu TAMAI¹, Shuzo TASHIMA¹, Kaori MUROMACHI¹, Yuji IWASHITA¹, Yuichiro NASU¹, Takeshi HORI¹, Hirohito TSUBOUCHI¹, Akio IDO³

¹Department of Gastroenterology，Kagoshima City Hospital, ²Maehara General Medical Hospital, ³Digestive and Lifestyle Diseases，Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences

キーワード : ascites, liver cirrhosis, noninvasive testing (NIT), POEMS syndrome, TAFRO syndrome

The patient was a Japanese male in his 70s who had previously been treated with an interferon preparation for chronic hepatitis C, but the treatment was ineffective. After edema appeared, computed tomography showed subcutaneous edema, pleural effusion, and ascites, and hepatic edema and ascites were initially suspected because of persistent hepatitis C virus (HCV) infection, thrombocytopenia, and a high FIB-4 index. Noninvasive testing (NIT), which included Mac2 binding protein glycosylation isomer (M2BPGi), ultrasound elastography, and congestion index of the portal vein, ruled out liver cirrhosis and hepatic ascites, and this case was ultimately considered to be TAFRO syndrome. The most common cause of ascites is liver cirrhosis, which is often treated by a hepatologist. Thus, it is important to objectively differentiate whether ascites is due to a hepatic cause using NIT. And since there have been no reports of HCV infection complicated by TAFRO syndrome, this case is rare and valuable.