Peginterferon-α-2a
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Reactions 1307 - 26 Jun 2010 S Peginterferon-α-2a Sarcoidosis reactivation: case report A 59-year-old woman with a history of sarcoidosis experienced disease reactivation during treatment with peginterferon-α-2a for chronic hepatitis C (HCV). The woman, who had developed sarcoidosis in 1983 and had been successfully treated with steroids, presented for treatment of chronic HCV with liver cirrhosis in July 2007. She started receiving weekly peginterferon-α-2a 180µg and ribavirin. Her HCV-RNA became undetectable from treatment week 12, and a total treatment duration of 48 weeks was scheduled. She developed persistent dry cough at week 4, which was attributed to ribavirin therapy. From 32 weeks of treatment, she developed fever of up to almost 39°C every evening, night sweats, and blue-red skin changes on both lower extremities consistent with erythema nodosum. An x-ray showed bihilar adenopathy compatible with stage I sarcoidosis. Her serum ACE and serum interleukin-2 receptor (S-sIL-2-R) levels were markedly elevated, and lung function tests showed low- grade obstruction (FEV1/VC 69% GOLD I). The woman’s erythema nodosum was treated with topical clobetasol propionate; antiviral therapy was continued under close observation. At week 40, a repeat lung function test was unremarkable, and x-rays showed stable adenopathy. Erythema nodosum had resolved at the time of therapy completion; episodic fever persisted until week 46. However, she lost over 10kg of body weight during the last 16 weeks of therapy. S-ACE and S-sIL-2-R level continued to increase until the end of therapy; 6 months later, her S-sIL-2-R level had normalised, and her S-ACE level was improving. A final diagnosis of interferon- α-induced sarcoidosis reactivation was made. She achieved a sustained virological response, and was in good general condition without clinical complaints 24 weeks after therapy completion. Author comment: Due to the history of sarcoidosis, this occurrence was interpreted as an interferon-α-induced reactivation of the pre-existing sarcoidosis, even though a temporal coincidence cannot be definitely excluded. Mederacke I, et al. Interferon-alfa induced reactivation of sarcoidosis in a patient with chronic hepatitis C. Internist 51: 522-527, No. 4, Apr 2010. Available from: URL: http://dx.doi.org/10.1007/s00108-009-2543-3 [German] - Germany 803021382 1 Reactions 26 Jun 2010 No. 1307 0114-9954/10/1307-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Peginterferon-α-2a
Reactions 1307 - 26 Jun 2010
SPeginterferon-α-2a
Sarcoidosis reactivation: case reportA 59-year-old woman with a history of sarcoidosis
experienced disease reactivation during treatment withpeginterferon-α-2a for chronic hepatitis C (HCV).
The woman, who had developed sarcoidosis in 1983 andhad been successfully treated with steroids, presented fortreatment of chronic HCV with liver cirrhosis in July 2007.She started receiving weekly peginterferon-α-2a 180µg andribavirin. Her HCV-RNA became undetectable fromtreatment week 12, and a total treatment duration of48 weeks was scheduled. She developed persistent drycough at week 4, which was attributed to ribavirin therapy.From 32 weeks of treatment, she developed fever of up toalmost 39°C every evening, night sweats, and blue-red skinchanges on both lower extremities consistent witherythema nodosum. An x-ray showed bihilar adenopathycompatible with stage I sarcoidosis. Her serum ACE andserum interleukin-2 receptor (S-sIL-2-R) levels weremarkedly elevated, and lung function tests showed low-grade obstruction (FEV1/VC 69% GOLD I).
The woman’s erythema nodosum was treated withtopical clobetasol propionate; antiviral therapy wascontinued under close observation. At week 40, a repeatlung function test was unremarkable, and x-rays showedstable adenopathy. Erythema nodosum had resolved at thetime of therapy completion; episodic fever persisted untilweek 46. However, she lost over 10kg of body weightduring the last 16 weeks of therapy. S-ACE and S-sIL-2-Rlevel continued to increase until the end of therapy;6 months later, her S-sIL-2-R level had normalised, and herS-ACE level was improving. A final diagnosis of interferon-α-induced sarcoidosis reactivation was made. She achieveda sustained virological response, and was in good generalcondition without clinical complaints 24 weeks aftertherapy completion.
Author comment: Due to the history of sarcoidosis, thisoccurrence was interpreted as an interferon-α-inducedreactivation of the pre-existing sarcoidosis, even though atemporal coincidence cannot be definitely excluded.Mederacke I, et al. Interferon-alfa induced reactivation of sarcoidosis in a patientwith chronic hepatitis C. Internist 51: 522-527, No. 4, Apr 2010. Available from:URL: http://dx.doi.org/10.1007/s00108-009-2543-3 [German] -Germany 803021382
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Reactions 26 Jun 2010 No. 13070114-9954/10/1307-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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