Possible induction of systemic lupus erythematosus by interferon-alpha treatment in a patient with a malignant carcinoid tumour.
Interferon-alpha (IFN-alpha) is currently used in the treatment of various malignant tumours. Development of different autoimmune disorders has been reported in some patients during IFN-alpha therapy. Systemic lupus erythematosus (SLE) after treatment with IFN-alpha has not been described, although a majority of SLE patients have demonstrable serum levels of IFN-alpha, which correlate with disease activity and have been suggested to be of pathogenetic significance. In this paper we describe a patient with a malignant carcinoid tumour who developed a SLE-like syndrome during treatment with leucocyte IFN-alpha. The patient developed myalgia and low grade arthritis in multiple joints together with a high titre of antinuclear antibodies (ANA) and anti-dsDNA antibodies. After the treatment was stopped, the symptoms subsided although a moderate ANA titre persisted. However, the tumour continued to regress despite cessation of IFN-alpha therapy. During a short course with recombinant IFN-alpha the syndrome relapsed, supporting the concept that the SLE syndrome was precipitated by IFN-alpha. A connection between IFN-alpha treatment, the induced autoimmune disorder and regression of the carcinoid tumour is suggested.
Ludwig Institute for Cancer Research, Uppsala Branch, Sweden.
L E
LE
Rönnblom
G V
GV
Alm
K E
KE
Oberg
D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis; D001063:Appendiceal Neoplasms / Q000628:therapy*; D002276:Carcinoid Tumor / Q000556:secondary / Q000628:therapy*; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007370:Interferon Type I / Q000009:adverse effects* / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000209:etiology*
D000974:Antibodies, Antinuclear; D007370:Interferon Type I; D006897:Hydroxyindoleacetic Acid