Case report: interferon induced coma in Sheehan's syndrome.
A 54-year-old woman who was being treated with 10 million units (mu) of natural interferon (IFN)-alpha per day for chronic active hepatitis C at a local clinic, developed coma on the fourth day of treatment. On admission to Yamagata University Hospital, she was still in a state of semicoma with severe hyponatraemia (122 mEq/L) and hypochloraemia (89 mEq/L). After the administration of electrolytes, her condition improved remarkably. Endocrinological loading tests showed a hypofunction of the anterior pituitary gland. In consideration of these results, and her past experiences of haemorrhage during childbirth and subsequent amenorrhoea, we diagnosed her illness as a coma as a result of Sheehan's syndrome which had become overt during IFN therapy. She recovered completely after treatment with hydrocortisone and l-thyroxine.
Mabe
K
K
Second Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Shinzawa
H
H
Yamatani
K
K
Takeda
T
T
Ishibashi
M
M
Yamada
N
N
Misawa
H
H
Wakabayashi
H
H
Togashi
H
H
Takahashi
T
T
D000324:Adrenocorticotropic Hormone / Q000494:pharmacology; D002908:Chronic Disease; D003128:Coma / Q000139:chemically induced* / Q000188:drug therapy; D004573:Electrolytes / Q000627:therapeutic use; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000627:therapeutic use; D007018:Hypopituitarism / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007372:Interferons / Q000009:adverse effects*; D008875:Middle Aged; D010902:Pituitary Gland / Q000503:physiopathology; D013974:Thyroxine / Q000627:therapeutic use
D004573:Electrolytes; D000324:Adrenocorticotropic Hormone; D007372:Interferons; D013974:Thyroxine; D006854:Hydrocortisone