Reactions 1506, p22 - 21 Jun 2014

SPeginterferon-α-2a/ribavirin

Guillain-Barre syndrome with acute psychosis: casereport

A 59-year-old woman developed Guillain-Barre syndromewith acute psychosis during treatment with peginterferon-α-2a [Pegasys] and ribavirin.

The woman had received 21 weeks of therapy withpeginterferon-α-2a and ribavirin for chronic hepatitis C [routesand dosages not stated]. She was hospitalised with rapidlyprogressive paraesthesias in her feet and arms, with weaknessand numbness, along with intense pain in her low thoracicspine region. Conduction studies were modified, spine MRIwas normal, and her CSF revealed albuminocytologicaldissociation, consistent with acute inflammatorydemyelinating polyneuropathy.

Peginterferon-α-2a and ribavirin were withdrawn; thewoman was treated with immunoglobulin G. However, herneurological status was aggravated during the first few days oftreatment, with bilateral Bell’s palsy and tetraparesis. She alsodeveloped vivid dreams and visual hallucinations, and wasagitated. Her neurological symptoms improved over thefollowing days. Her mental state abnormalities resolved aftertreatment with neuroleptics. After 6 weeks of neurologicalrehabilitation, she partially recovered.

Author comment: "The first line treatment for chronichepatitis C is the combination of PEG-IFN [peginterferon] andRibavirin. There are a few reports of acute inflammatorydemyelinating polyneuropathy (AIDP) as a neurological sideeffect of this therapy. Psychiatric side effects such asdepressive disorders, panic attacks and mental statusabnormalities are likely to appear during immunomodulatingtherapy but also in the course of AIDP."Vanta OM, et al. Guillain-Barre syndrome with acute psychotic disorder duringtherapy with PEG-IFN and Ribavirin for chronic hepatitis C: A case report.European Journal of Neurology 21 (Suppl. 1): 546 abstr. PP2246, May 2014 -Romania 803104968

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Reactions 21 Jun 2014 No. 15060114-9954/14/1506-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved