Reactions 596 - 13 Apr 1996

SInterferon-α-2b

Cardiogenic shock: case reportCardiogenic shock, probably as a result of perimyocarditis,

developed in a 57-year-old woman who was treated with IMinterferon-α-2b 6 MU/day.

The patient had a fever of 38°C during the first 4 days oftherapy; this then resolved. After 46 days’ treatment withinterferon-α-2b, she vomited and began to loseconsciousness. On admission to hospital, her HR was 47/minand her BP was 50/30mm Hg. Her myocardial enzyme levelswere raised as follows: lactate dehydrogenase 834 IU/L,creatine phosphokinase 754 IU/L and creatine phosphokinase-MB 76 IU/L. She had evidence of hypoxaemia with an oxygenpartial pressure of 53.8mm Hg and an ECG showed completeatrioventricular block. An echocardiogram revealed thickeningof the anterior wall of the left ventricle, reduced movement ofthe intraventricular septum and anterior wall and pericardialeffusion. She had a decreased cardiac index of 1.99 L/min/m2

with an elevated mean pulmonary wedge pressure of 27mmHg.

The woman was diagnosed with cardiogenic shock andinterferon-α-2b therapy was stopped. Her cardiac functionimproved 3 weeks after she started therapy with diuretics,catecholamines, transient pacing and intra-aortic balloonpump treatment.

Author comment: ‘Our findings suggest that IFN [interferon]therapy influenced the occurrence of cardiogenic shock. It isnecessary to carefully monitor the patient for cardiovascularsigns during IFN therapy, bearing in mind the possibility ofcardiogenic shock as well as other adverse drug reactions.’Teragawa H, et al. Cardiogenic shock following recombinant alpha-2b interferontherapy for chronic hepatitis C: a case report. Japanese Heart Journal 37: 137-142,Jan 1996 - Japan 800433430

1

Reactions 13 Apr 1996 No. 5960114-9954/10/0596-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved