Interferon-α-2b/ribavirin
1
Reactions 866 - 25 Aug 2001 ★ Interferon-α-2b/ribavirin First report of lupus anticoagulant: case report During treatment with interferon-α-2b plus ribavirin for a chronic hepatitis C infection, a 60-year-old woman developed lupus anticoagulant. The woman received treatment with interferon-α-2b 5MU 3 times weekly and ribavirin 1000 mg/day. After 1 month’s treatment, a complete response to this therapy had been achieved. The ribavirin dosage was then adjusted [dosage not stated] due to a falling haemoglobin level. After 10 weeks’ treatment, her activated partial thromboplastin time had become prolonged at 93 seconds (normal 25–38), her fibrinogen level was 588 mg/dl (200–400) and the coagulation activity of factors IX, XI and XII was reduced. Lupus anticoagulant was detected at a level of 1.66 (normal 0.8–1.2) by a diluted Russell’s viper venom test. Treatment with interferon-α-2b and ribavirin was discontinued. Two weeks later, a repeat lupus anticoagulant test was negative. The woman’s activated partial thromboplastin time had normalised 6 weeks later. During 3 months of follow-up, she remained in sustained response. Author comment: ‘The temporal relationship supports the idea that this complication was secondary to the treatment, rather than to the viral infection itself, or to an exacerbated liver cell necrosis/apoptosis. The reversion of the coagulation disorder eight weeks after therapy was discontinued further suggests an adverse drug reaction, probably to interferon-α.’ Carmona-Soria I, et al. Development of lupic anticoagulant during combination therapy in a patient with chronic hepatitis C. Journal of Hepatology 34: 965-967, Jun 2001 - Spain 800875034 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of lupus anticoagulant associated with interferon-α-2b or ribavirin; however, lupus anticoagulant has been reported in association with interferon- α-2a [see Reactions 611: 8, 27 Jul 1996; 800457195]. 1 Reactions 25 Aug 2001 No. 866 0114-9954/10/0866-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Interferon-α-2b/ribavirin
Reactions 866 - 25 Aug 2001
★Interferon-α-2b/ribavirin
First report of lupus anticoagulant: case reportDuring treatment with interferon-α-2b plus ribavirin for a
chronic hepatitis C infection, a 60-year-old woman developedlupus anticoagulant.
The woman received treatment with interferon-α-2b 5MU 3times weekly and ribavirin 1000 mg/day. After 1 month’streatment, a complete response to this therapy had beenachieved. The ribavirin dosage was then adjusted [dosage notstated] due to a falling haemoglobin level. After 10 weeks’treatment, her activated partial thromboplastin time hadbecome prolonged at 93 seconds (normal 25–38), herfibrinogen level was 588 mg/dl (200–400) and the coagulationactivity of factors IX, XI and XII was reduced. Lupusanticoagulant was detected at a level of 1.66 (normal 0.8–1.2)by a diluted Russell’s viper venom test.
Treatment with interferon-α-2b and ribavirin wasdiscontinued. Two weeks later, a repeat lupus anticoagulanttest was negative. The woman’s activated partialthromboplastin time had normalised 6 weeks later. During 3months of follow-up, she remained in sustained response.
Author comment: ‘The temporal relationship supports theidea that this complication was secondary to the treatment,rather than to the viral infection itself, or to an exacerbated livercell necrosis/apoptosis. The reversion of the coagulationdisorder eight weeks after therapy was discontinued furthersuggests an adverse drug reaction, probably to interferon-α.’Carmona-Soria I, et al. Development of lupic anticoagulant during combinationtherapy in a patient with chronic hepatitis C. Journal of Hepatology 34: 965-967,Jun 2001 - Spain 800875034
» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of lupus anticoagulantassociated with interferon-α-2b or ribavirin; however, lupusanticoagulant has been reported in association with interferon-α-2a [see Reactions 611: 8, 27 Jul 1996; 800457195].
1
Reactions 25 Aug 2001 No. 8660114-9954/10/0866-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
