Interferon-α-2a

Reactions 597 - 20 Apr 1996 S Interferon-α-2a Myasthenia gravis: case report A 64-year-old man developed severe myasthenia gravis after he was given interferon-α-2a therapy for chronic hepatitis C virus infection. The patient’s brother had had myasthenia gravis which had been treated successfully with a thymectomy. After 6 weeks’ therapy with SC interferon-α-2a 6MU thrice weekly, the patient noted weakness of his neck, eye and throat muscles, right ptosis and dysphonia. His symptoms improved significantly after he was treated with IM neostigmine. His serum anti-acetylcholine receptor antibody titre was 12 pmol/ ml (normal 0). The man discontinued interferon-α-2a therapy and was treated with pyridostigmine. Eight days later, he had a severe respiratory crisis and was admitted to an intensive care unit. His condition improved rapidly after he was treated with plasmapheresis and corticosteroids. He was discharged on anticholinesterase therapy and low-dose methylprednisolone and at follow-up, 8 months later, he was asymptomatic. Author comment: ‘Interferon-α treatment should not be given or at least given very carefully, to patients with evidence of familial myasthenia gravis.’ Mase G, et al. Development of myasthenia gravis during interferon-alpha treatment for anti-HCV positive chronic hepatitis. Journal of Neurology, Neurosurgery and Psychiatry 60: 348-349, Mar 1996 - Italy 800433133 1 Reactions 20 Apr 1996 No. 597 0114-9954/10/0597-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Transcript of Interferon-α-2a

Reactions 597 - 20 Apr 1996

SInterferon-α-2a

Myasthenia gravis: case reportA 64-year-old man developed severe myasthenia gravis after

he was given interferon-α-2a therapy for chronic hepatitis Cvirus infection. The patient’s brother had had myastheniagravis which had been treated successfully with athymectomy.

After 6 weeks’ therapy with SC interferon-α-2a 6MU thriceweekly, the patient noted weakness of his neck, eye and throatmuscles, right ptosis and dysphonia. His symptoms improvedsignificantly after he was treated with IM neostigmine. Hisserum anti-acetylcholine receptor antibody titre was 12 pmol/ml (normal 0).

The man discontinued interferon-α-2a therapy and wastreated with pyridostigmine. Eight days later, he had a severerespiratory crisis and was admitted to an intensive care unit.His condition improved rapidly after he was treated withplasmapheresis and corticosteroids. He was discharged onanticholinesterase therapy and low-dose methylprednisoloneand at follow-up, 8 months later, he was asymptomatic.

Author comment: ‘Interferon-α treatment should not begiven or at least given very carefully, to patients with evidence offamilial myasthenia gravis.’Mase G, et al. Development of myasthenia gravis during interferon-alpha treatmentfor anti-HCV positive chronic hepatitis. Journal of Neurology, Neurosurgery andPsychiatry 60: 348-349, Mar 1996 - Italy 800433133