Interferon-α/interferon-α-2b

Reactions 919 - 14 Sep 2002 ★ S Interferon-α/interferon-α-2b First report of multiple sclerosis: case report A 29-year-old woman developed multiple sclerosis while receiving treatment with interferon-α-2b [‘Intron A’] followed by interferon-α [‘Sumiferon’] for chronic myeloid leukaemia. The woman, who was pregnant, received a daily SC injection of interferon-α-2b 10 MIU and achieved a complete response after 4 months. Following the birth of her baby 2 months later, her interferon-α-2b dose was reduced. Almost 3 years after the initiation of interferon-α-2b, while receiving interferon-α-2b 6 MIU/day, she complained of headache and back pain. The following day, she was admitted to hospital with progressive visual disturbance. Neurological examinations revealed a substantial loss of bilateral visual acuity and a mild sensory deficit of her lower limbs. An MRI showed gadolinium enhanced areas in her optic chiasma and thoracic spine, and a T2-weighted image showed a high-intensity lesion in her right frontal subcortical white matter. Her myelin basic protein level was slightly elevated (15.6 ng/ml) and perimetry revealed enlarged central scotomas, diagnostic of bilateral optic neuritis. These observations were considered compatible with multiple sclerosis and interferon-α-2b was discontinued. The woman received IV methylprednisolone treatment and her neurological impairments, other than that of her central vision, subsided. Interferon-α 3 MIU/day was started in place of interferon-α-2b and, 2 days later, she suddenly complained of severe pain in her back and lower limbs. These symptoms subsided but, after 2 weeks of interferon-α treatment, she developed acute paraplegia and loss of micturition desire. These episodes, along with the clinical evidence of lesions, made a definitive diagnosis of multiple sclerosis. Interferon-α was discontinued and she received high-dose methylprednisolone. At last follow-up, MRI and clinical observation did not reveal any further neurological deterioration. Author comment: ‘It is possible that IFN-α [interferon-α] activates cellular immunoreactivity so as to facilitate autoimmune process specific to myelin-antigen.’ Kataoka I, et al. Multiple sclerosis associated with interferon-alpha therapy for chronic myelogenous leukemia. American Journal of Hematology 70: 149-153, Jun 2002 - Japan 807209858 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of multiple sclerosis associated with interferon-α or interferon-α-2b. The WHO Adverse Drug Reactions database contained 1 report of multiple sclerosis aggravation following interferon-α-2b treatment. 1 Reactions 14 Sep 2002 No. 919 0114-9954/10/0919-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Upload
vunhan
Category

Documents
view
214
download
1

Embed Size (px):

Transcript of Interferon-α/interferon-α-2b

Reactions 919 - 14 Sep 2002

★ SInterferon-α/interferon-α-2b

First report of multiple sclerosis: case reportA 29-year-old woman developed multiple sclerosis while

receiving treatment with interferon-α-2b [‘Intron A’] followedby interferon-α [‘Sumiferon’] for chronic myeloid leukaemia.

The woman, who was pregnant, received a daily SC injectionof interferon-α-2b 10 MIU and achieved a complete responseafter 4 months. Following the birth of her baby 2 months later,her interferon-α-2b dose was reduced. Almost 3 years after theinitiation of interferon-α-2b, while receiving interferon-α-2b 6MIU/day, she complained of headache and back pain. Thefollowing day, she was admitted to hospital with progressivevisual disturbance. Neurological examinations revealed asubstantial loss of bilateral visual acuity and a mild sensorydeficit of her lower limbs. An MRI showed gadoliniumenhanced areas in her optic chiasma and thoracic spine, and aT2-weighted image showed a high-intensity lesion in her rightfrontal subcortical white matter. Her myelin basic protein levelwas slightly elevated (15.6 ng/ml) and perimetry revealedenlarged central scotomas, diagnostic of bilateral opticneuritis.

These observations were considered compatible withmultiple sclerosis and interferon-α-2b was discontinued. Thewoman received IV methylprednisolone treatment and herneurological impairments, other than that of her central vision,subsided. Interferon-α 3 MIU/day was started in place ofinterferon-α-2b and, 2 days later, she suddenly complained ofsevere pain in her back and lower limbs. These symptomssubsided but, after 2 weeks of interferon-α treatment, shedeveloped acute paraplegia and loss of micturition desire.These episodes, along with the clinical evidence of lesions,made a definitive diagnosis of multiple sclerosis. Interferon-αwas discontinued and she received high-dosemethylprednisolone. At last follow-up, MRI and clinicalobservation did not reveal any further neurologicaldeterioration.

Author comment: ‘It is possible that IFN-α [interferon-α]activates cellular immunoreactivity so as to facilitateautoimmune process specific to myelin-antigen.’Kataoka I, et al. Multiple sclerosis associated with interferon-alpha therapy forchronic myelogenous leukemia. American Journal of Hematology 70: 149-153, Jun2002 - Japan 807209858

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of multiple sclerosisassociated with interferon-α or interferon-α-2b. The WHOAdverse Drug Reactions database contained 1 report of multiplesclerosis aggravation following interferon-α-2b treatment.