Secondary hyperparathyroidism exacerbation: a rare side-effect of interferon-alpha?
Recombinant human interferon alpha (alpha IFN) is the only treatment with proven benefit for chronic hepatitis C virus (HCV) infection. Nevertheless its use in some susceptible individuals has led to the development or aggravation of different autoimmune conditions. We report the case of a 20 year old woman on peritoneal dialysis with chronic lobular hepatitis secondary to HCV infection who developed de novo psoriasis 9 months after starting treatment with alpha-IFN. In addition to psoriasis, alpha-IFN prescription was also concurrent with an unexpected and refractory secondary hyperparathyroidism exacerbation initially characterized by a marked reduction of serum calcium levels and a consequential increase of PTH. Both complications disappeared after drug withdrawal. The clinical sequence makes an alpha-IFN-induced autoimmune side effect the most plausible hypothesis. The case is discussed and some possible etiopathogenic factors are briefly reviewed.
Calvino
J
J
Division of Nephrology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.
Romero
R
R
Suárez-Peñaranda
J M
JM
Arcocha
V
V
Lens
X M
XM
Mardaras
J
J
Novoa
D
D
Sánchez-Guisande
D
D
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects*; D001706:Biopsy; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000473:pathology / Q000628:therapy; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000139:chemically induced* / Q000473:pathology; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D010530:Peritoneal Dialysis; D011565:Psoriasis / Q000139:chemically induced / Q000473:pathology; D011994:Recombinant Proteins; D012008:Recurrence; D012867:Skin / Q000473:pathology
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins