title: Secondary hyperparathyroidism exacerbation: a rare side-effect of interferon-alpha?
abstract: 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.
authors.affiliation: Division of Nephrology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Calvino
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: J M
authors.initials: JM
authors.lastname: Suárez-Peñaranda
authors.forename: V
authors.initials: V
authors.lastname: Arcocha
authors.forename: X M
authors.initials: XM
authors.lastname: Lens
authors.forename: J
authors.initials: J
authors.lastname: Mardaras
authors.forename: D
authors.initials: D
authors.lastname: Novoa
authors.forename: D
authors.initials: D
authors.lastname: Sánchez-Guisande
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins