Carrillo-Esper R; González-Avila D; Uribe-Ríos M; Méndez-Sánchez N

Language: Spanish
References: 18
Page: 87-90
PDF size: 226.18 Kb.

Text Extraction

Since 2004, pegylated interferon (P-IFN) in combination with ribavirin has become the optimal choice of therapy for chronic hepatitis C virus (HCV) infection. IFN a-2b suppresses HCV replication and restores elevated serum aminotransferase levels, leading to improvements in the histological changes in the livers of patients with chronic hepatitis C.1 Unfortunately, P-IFN has several adverse effects, including pneumonitis. This complication has been reported in the treatment of malignant diseases and CHC.2 We report a patient with interstitial pneumonitis thought to be caused by an IFN-based treatment in an unusual scenario of a patient with HCV-related Child–Pugh stage A cirrhosis, who experienced dyspnea, fever, and cough after 12 months of treatment with P-IFN a-2b. Her lung injury and pulmonary symptoms did not disappear despite discontinuation of IFN and the administration of corticosteroid. We concluded that the patient developed a fatal interstitial pneumonitis associated with P-INF a-2b therapy.

REFERENCES

1. Strader DB, Wright T, Thomas DL, Seeff LB. American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C. Hepatology 2004; 39: 1147-71.

2. Chen YC, Lu S-N, Lin M-C. Interstitial pneumonitis after combination therapy with pegylated interferon a-2b and ribavirin for chronic hepatitis C. Chang Gung Med J 2007; 30: 92-7.

3. Tahan V, Ozseker F, Guneylioglu D, Baran A, Ozaras R, Mert A, Ucisik AC, et al. Sarcoidosis after use of interferon for chronic hepatitis C: report of a case and review of the literature. Dig Dis Sci 2003; 48: 169-73.

4. Kumar KS, Russo MW, Borczuk AC, Brown M, Esposito SP, Lobritto SJ, Jacobson IM, et al. Significant pulmonary toxicity associated with interferon and ribavirin therapy for hepatitis C. Am J Gastroenterol 2002; 97: 2432-40.

5. Hizawa N, Kojima J, Kojima T, Sukoh N, Yamaguchi E, Kawakami Y, Matsushima T. A patient with chronic hepatitis C who simultaneously developed interstitial pneumonia, hemolytic anemia and cholestatic liver dysfunction after alpha-interferon administration. Intern Med 1994; 33: 337-41.

6. Rönnblom LE, Alm GV, Oberg KE. Autoimmunity after alpha-interferon therapy for malignant carcinoid tumors. Ann Intern Med 1991; 115: 178-83.

7. Midturi J, Sierra-Hoffman M, Hurley D, Winn R, Beissner R, Carpenter J. Spectrum of pulmonary toxicity associated with the use of interferon therapy for hepatitis C: Case report and review of the literature. Clin Infect Dis 2004; 39: 1724-9.

8. Glue P, Fang JW, Rouzier-Panis R, Raffanel C, Sabo R, Gupta SK, Salfi M, et al. Pegylated interferon-a2b: pharmacokinetics, pharmacodynamics, safety, and preliminary efficacy data. Hepatitis C Intervention Therapy Group. Clin Pharmacol Ther 2000; 68: 556-67.

9. Kowdley KV. Hematological side effects of interferon and ribavirin therapy. J Clin Gastroenterol 2005; 39 Suppl 1: S3-S8.

10. Benítez C, Andresen M, Farías G, Castillo C, Henríquez M, Pereira J. Indications, adverse effects and results of plasmapheresis in critical care patients. Rev Med Chil 2005; 133: 1441-8.

11. Lang ZW, Shen B, Zhang L, Shi XH, Ma PQ, Lan MD, Ma ZC, et al. Detection of CD4+CD25+ regulatory T cells in liver tissues of fibrosing cholestatic hepatitis after liver and kidney transplantation. Zhonghua Gan Zang Bing Za Zhi 2007; 15: 667-71.

12. Kojima H, Abei M, Takei N, Mukai Y, Hasegawa Y, Iijima T, Nagasawa T. Fatal reactivation of hepatitis B virus following cytotoxic chemotherapy for acute myelogenous leukemia: fibrosing cholestatic hepatitis. Eur J Hematol 2002; 69: 101-4.

13. Izquierdo MT, Almenar L, Zorio E, Martinez-Dolz L. Viral hepatitis C-related fibrosing cholestatic hepatitis after cardiac transplantation. Med Clin (Barc) 2007; 129: 117-8.

14. Hooda AK, Puri P, Narula AS, Raychaudhury N, Varghese SJ, Basu A. Hepatitis C virus-related fibrosing cholestatic hepatitis in a renal transplant recipient. Indian J Gastroenterol 2006; 25: 308-9.

15. Chen JW, Chen DZ, Chen ZM. Unique pattern of fibrosing cholestatic hepatitis after liver transplantation. Hepatobiliary Pancreat Dis Int 2002; 1: 33-4.

16. Saleh F, Ko HH, Davis JE, Apiratpracha W, Powell JJ, Erb SR, Yoshida EM. Fatal hepatitis C associated fibrosing cholestatic hepatitis as a complication of cyclophosphamide and corticosteroid treatment of active glomerulonephritis. Ann Hepatol 2007; 6: 186-9.

17. Abi-Nassif S, Mark EJ, Fogel RB, Hallisey RK Jr. Pegylated interferon and ribavirin-induced interstitial pneumonitis with ARDS. Chest 2003; 124: 406-10.

18. Chin K, Tabata C, Sataka N, Nagai S, Moriyasu F, Kuno K. Pneumonitis associated with natural and recombinant interferon alfa therapy for chronic hepatitis C. Chest 1994; 105: 939-41.