Retinal complications with elevated circulating plasma C5a associated with interferon-alpha therapy for chronic active hepatitis C.
Retinal hemorrhage is a complication of interferon therapy of unknown pathogenesis. We report two chronic active hepatitis C patients who developed retinal hemorrhage and/or cotton wool patches during interferon-alpha therapy 4 and 12 wk after beginning treatment. At the time of the hemorrhage, plasma-activated complement 5, a known potent intravascular aggregator of granulocytes, increased to 54 ng/ml in one patient and to 29 ng/ml in the other patient. When the hemorrhage resolved, it decreased to under 5 ng/ml. Our cases suggest that complement activation occurs in patients treated with interferon-alpha and that activation of complement 5 can lead to retinal capillary infarction and retinal hemorrhage. High levels of activated complement 5 may predict retinal artery infarction or perhaps microvascular emboli in the other organs.
Sugano
S
S
Saiseikai Wakakusa Hospital, Yokohama, Japan.
Yanagimoto
M
M
Suzuki
T
T
Sato
M
M
Onmura
H
H
Aizawa
H
H
Makino
H
H
D003167:Complement Activation; D015936:Complement C5a / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006526:Hepatitis C / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000628:therapy*; D006801:Humans; D007238:Infarction / Q000209:etiology; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011994:Recombinant Proteins; D012164:Retinal Diseases / Q000209:etiology; D012166:Retinal Hemorrhage / Q000209:etiology*; D013997:Time Factors
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015936:Complement C5a