Reactions 1182 - 15 Dec 2007

Interferon-α-2a

Pulmonary tuberculosis: case reportA 30-year-old man developed pulmonary tuberculosis

during treatment with interferon-α-2a for chronic hepatitis C.The man was diagnosed with chronic hepatitis C and

subsequently started receiving interferon-α-2a (3 million unitsthree times weekly).Three months after starting interferon-α-2a, he developed an insidious onset of dyspnoea onexertion, coughing, wheezing and an occasional fever. About6 months after diagnosis of hepatitis C, he presented with a2-week history of a productive cough, night sweats, fever anddyspnoea; he had received antibacterials for 1 week forsuspected pneumonia, but had no improvement. Onexamination, his expiration was prolonged, and he had ralesand diffuse wheezing. Chest x-ray showed left lung opacity,and CT scan showed infiltration and cavities in the middle andlower left lung. Tuberculin skin test, cultures and nucleic acidamplification assays were positive for tuberculosis.

The man received rifampicin, pyrazinamide, ethambutol,isoniazid and pyridoxine [vitamin B6]. Interferon-α-2a wasstopped. After 3 weeks, he had improvement in his fever,cough and dyspnoea, and he felt better. He receivedtuberculosis treatment for 6 months in total.

Author comment: "Use of the Naranjo probability scaleindicated a possible relationship between [tuberculosis] andinterferon treatment in out patient (final score 4)."Farah R, et al. The association of interferon with the development of pulmonarytuberculosis. International Journal of Clinical Pharmacology and Therapeutics 45:598-600, No. 11, Nov 2007 - Israel 801080287

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Reactions 15 Dec 2007 No. 11820114-9954/10/1182-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved