Primary biliary cirrhosis induced by interferon-alpha therapy for hepatitis C virus infection.
Interferon-alpha is known to exacerbate and in some cases induce a variety of autoimmune disorders. In this report we describe the onset of primary biliary cirrhosis in a 55-year-old woman without evidence of preexisting autoimmune diseases receiving recombinant interferon-alpha 2a for chronic active hepatitis C. Shortly after discontinuing interferon therapy, alkaline phosphatase levels started to rise up to three times the normal range. Anti-mitochondrial antibodies were found to be positive at a high titer, and liver biopsy showed a picture of chronic active hepatitis along with primary biliary cirrhosis features (overlap syndrome). Primary biliary cirrhosis should be considered in the differential diagnosis in any patient treated with interferon-alpha with unexplained elevation of serum alkaline phosphatase.
D'Amico
E
E
Ospedale di Pescara, Divisione di Reumatologia, Italy.
Paroli
M
M
Fratelli
V
V
Palazzi
C
C
Barnaba
V
V
Callea
F
F
Consoli
G
G
D000998:Antiviral Agents / Q000009:adverse effects*; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects*; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000139:chemically induced* / Q000175:diagnosis; D008875:Middle Aged; D011994:Recombinant Proteins; D013997:Time Factors
D000998:Antiviral Agents; D007370:Interferon Type I; D011994:Recombinant Proteins