Interferon-α-2b/peginterferon-α-2b
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Reactions 1037 - 5 Feb 2005 ★ S Interferon-α-2b/peginterferon-α-2b Pure red cell aplasia (first report with peginterferon- α-2b): case report A 50-year-old female liver transplant recipient developed pure red cell aplasia during treatment with interferon-α-2b and peginterferon-α-2b for recurrent hepatitis C virus infection. The woman received interferon-α-2b 3 million units three times weekly for 4 weeks, followed by peginterferon-α-2b 25 µg/week; her concomitant medication included sirolimus, tacrolimus and prednisone. After 5 months’ treatment, she developed pancytopenia, with severe anaemia and liver enzyme elevation; a liver biopsy was consistent with allograft rejection. Peginterferon-α-2b was discontinued and the woman’s leucopenia and thrombocytopenia resolved. However, transfusion-dependent anaemia persisted and, 3 months after the discontinuation of antiviral therapy, she had a haemoglobin level of 2.9 g/dL, marked reticulocytopenia and an elevated serum erythropoietin level. A bone marrow biopsy revealed 30% cellularity, significantly decreased erythroid precursors and a significantly elevated myeloid:erythroid ratio (> 20:1); pure red cell aplasia was diagnosed. She was treated with IV immunoglobulins and, after 10 days, reticulocytosis and stabilisation of her haemoglobin level were observed. Her anaemia did not recur during > 10 months follow-up. Author comment: "We conclude that this patient’s pure red cell aplasia may have been triggered by interferon α, likely associated with the known complex immunological activities of interferon α that may lead to the de novo development of autoimmunity." Arcasoy MO, et al. Pure red cell aplasia following pegylated interferon alpha treatment. American Journal of Medicine 117: 619-620, No. 8, 15 Oct 2004 - USA 800995109 » Editorial comment: A search of AdisBase, Medline and the WHO Adverse Drug Reactions database did not reveal any previous case reports of pure red cell aplasia associated with peginterferon-α-2b. 1 Reactions 5 Feb 2005 No. 1037 0114-9954/10/1037-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
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Transcript of Interferon-α-2b/peginterferon-α-2b
Reactions 1037 - 5 Feb 2005
★ SInterferon-α-2b/peginterferon-α-2b
Pure red cell aplasia (first report with peginterferon-α-2b): case report
A 50-year-old female liver transplant recipient developedpure red cell aplasia during treatment with interferon-α-2b andpeginterferon-α-2b for recurrent hepatitis C virus infection.
The woman received interferon-α-2b 3 million units threetimes weekly for 4 weeks, followed by peginterferon-α-2b25 µg/week; her concomitant medication included sirolimus,tacrolimus and prednisone. After 5 months’ treatment, shedeveloped pancytopenia, with severe anaemia and liverenzyme elevation; a liver biopsy was consistent with allograftrejection.
Peginterferon-α-2b was discontinued and the woman’sleucopenia and thrombocytopenia resolved. However,transfusion-dependent anaemia persisted and, 3 months afterthe discontinuation of antiviral therapy, she had ahaemoglobin level of 2.9 g/dL, marked reticulocytopenia andan elevated serum erythropoietin level. A bone marrow biopsyrevealed 30% cellularity, significantly decreased erythroidprecursors and a significantly elevated myeloid:erythroid ratio(> 20:1); pure red cell aplasia was diagnosed. She was treatedwith IV immunoglobulins and, after 10 days, reticulocytosisand stabilisation of her haemoglobin level were observed. Heranaemia did not recur during > 10 months follow-up.
Author comment: "We conclude that this patient’s purered cell aplasia may have been triggered by interferon α, likelyassociated with the known complex immunological activitiesof interferon α that may lead to the de novo development ofautoimmunity."Arcasoy MO, et al. Pure red cell aplasia following pegylated interferon alphatreatment. American Journal of Medicine 117: 619-620, No. 8, 15 Oct 2004 -USA 800995109
» Editorial comment: A search of AdisBase, Medline and theWHO Adverse Drug Reactions database did not reveal anyprevious case reports of pure red cell aplasia associated withpeginterferon-α-2b.
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Reactions 5 Feb 2005 No. 10370114-9954/10/1037-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
