title: Severe vaginal bleeding associated with recombinant interferon beta-1B.
abstract: OBJECTIVE
  To report a case of severe vaginal bleeding associated with interferon beta-1b (IFN-beta).
  
  
  METHODS
  A 19-year-old white woman diagnosed with multiple sclerosis was treated with IFN-beta 4 million IU every other day for 1 month. After 1 month, the dosage was increased to 8 million IU. The patient subsequently experienced severe vaginal bleeding. Because her hemoglobin was 3.9 g/dL, she was admitted to the hospital for treatment and observation. IFN-beta was discontinued and she was treated with conjugated estrogens and received 2 units of packed red blood cells. The bleeding ceased and the patient was discharged in stable condition.
  
  
  CONCLUSIONS
  Menstrual disorders of mild-to-moderate severity were reported during clinical trials with IFN-beta. This is the first case report regarding severe vaginal bleeding probably associated with IFN-beta. The mechanism for development of IFN-beta-related menstrual disorders is unknown.
  
  
  CONCLUSIONS
  Reports of menstrual disorders associated with recombinant IFN-beta are rare; however, clinicians should be aware that this complication can occur. Should menstrual disorders occur with no other etiologic factors identified, IFN-beta should be discontinued, with improvement expected shortly thereafter.
authors.affiliation: Regional Health Services, Hamot Health Foundation, Erie, PA 16550, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Pakulski
authors.forename: L M
authors.initials: LM
authors.lastname: DiMarco
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016899:Interferon-beta / Q000009:adverse effects*; D008599:Menstruation Disturbances / Q000139:chemically induced; D014592:Uterine Hemorrhage / Q000139:chemically induced* / Q000628:therapy
chemical_list: D004966:Estrogens, Conjugated (USP); D016899:Interferon-beta