Peginterferon-α-2a/ribavirin withdrawal
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Reactions 1312 - 31 Jul 2010 S Peginterferon-α-2a/ribavirin withdrawal Autoimmune enteropathy in an elderly patient: case report A 65-year-old man developed autoimmune enteropathy after withdrawal of peginterferon-α-2a and ribavirin therapy for hepatitis C. The man, who had a history of ulcerative colitis and total colectomy, received peginterferon-α-2a and ribavirin [dosages not stated] for 6 months. Treatment was then discontinued because of persistent viraemia. Five weeks later, he presented with severe watery diarrhoea through his ostomy. Over the following 6 weeks, he was hospitalised frequently because of persistent diarrhoea and dehydration, and lost 20 pounds in weight. Endoscopy of the small bowel with ileoscopy and enteroscopy revealed mild loss of folds in the ileum. Biopsies showed a lymphocytic infiltrate and severe villous blunting. The man received diphenoxylate/atropine, colestyramine, loperamide, tincture of opium and octreotide, and went on a gluten-free diet, but his diarrhoea did not respond. He started receiving budesonide; his diarrhoea rapidly improved, and resolved completely after 2 weeks. Immunofluorescence was positive for anti- enterocyte IgG antibodies. At 7 months’ follow-up, after his budesonide dose was decreased, he relapsed. Ileoscopy showed friability of mucosa and diffuse erythema. Biopsies revealed chronic inflammatory infiltrate with numerous plasma lymphocytes, shortened villi and multiple apoptotic bodies. His budesonide dose was increased and he received prednisone tapered over 12 weeks. He had prompt remission of symptoms. Gonzalez G, et al. Autoimmune enteropathy associated with cessation of interferon-alpha therapy in chronic hepatitis C. Digestive Diseases and Sciences 55: 1490-3, No. 5, May 2010 - USA 803028371 1 Reactions 31 Jul 2010 No. 1312 0114-9954/10/1312-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Peginterferon-α-2a/ribavirin withdrawal
Reactions 1312 - 31 Jul 2010
SPeginterferon-α-2a/ribavirinwithdrawal
Autoimmune enteropathy in an elderly patient:case report
A 65-year-old man developed autoimmune enteropathyafter withdrawal of peginterferon-α-2a and ribavirintherapy for hepatitis C.
The man, who had a history of ulcerative colitis and totalcolectomy, received peginterferon-α-2a and ribavirin[dosages not stated] for 6 months. Treatment was thendiscontinued because of persistent viraemia. Five weekslater, he presented with severe watery diarrhoea throughhis ostomy. Over the following 6 weeks, he washospitalised frequently because of persistent diarrhoea anddehydration, and lost 20 pounds in weight. Endoscopy ofthe small bowel with ileoscopy and enteroscopy revealedmild loss of folds in the ileum. Biopsies showed alymphocytic infiltrate and severe villous blunting.
The man received diphenoxylate/atropine,colestyramine, loperamide, tincture of opium andoctreotide, and went on a gluten-free diet, but his diarrhoeadid not respond. He started receiving budesonide; hisdiarrhoea rapidly improved, and resolved completely after2 weeks. Immunofluorescence was positive for anti-enterocyte IgG antibodies. At 7 months’ follow-up, after hisbudesonide dose was decreased, he relapsed. Ileoscopyshowed friability of mucosa and diffuse erythema. Biopsiesrevealed chronic inflammatory infiltrate with numerousplasma lymphocytes, shortened villi and multiple apoptoticbodies. His budesonide dose was increased and hereceived prednisone tapered over 12 weeks. He hadprompt remission of symptoms.Gonzalez G, et al. Autoimmune enteropathy associated with cessation ofinterferon-alpha therapy in chronic hepatitis C. Digestive Diseases and Sciences55: 1490-3, No. 5, May 2010 - USA 803028371
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Reactions 31 Jul 2010 No. 13120114-9954/10/1312-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
