A case of polymyositis with dilated cardiomyopathy associated with interferon alpha treatment for hepatitis B.
Polymyositis is a rare complication of interferon alpha treatment as a result of immune-modulating role of the drug itself. In this case, interferon alpha induced polymyositis and cardiomyopathy is diagnosed in a 33-yr-old male patient with history of chronic hepatitis B. To treat hepatitis B, interferon alpha was administered until the proximal muscle weakness developed. Thereafter, sixteen cycles of immunoglobulin treatment (400 mg/kg) along with corticosteroids were instituted and led to an improvement in subjective symptoms with decreases in level of CPK and LDH. However, dilated cardiomyopathy has not improved in spite of the cessation of interferon treatment. Unlike the persistently elevated serum HBV DNA level, the serum ALT and AST levels have gradually decreased. Our case shows that clinical symptoms of polymyositis improved with steroid and immunoglobulin treatment without deterioration of the hepatitis B. To our knowledge, this is the first case of polymyositis associated with dilated cardiomyopathy after the administration of interferon in a patient with hepatitis B.
Lee
Seung Won
SW
The Hospital for Rheumatic Diseases, Hanyang University, 17 Haengdong-dong, Seongdong-gu, Seoul 133-792, Korea.
Kim
Ki Chan
KC
Oh
Dong Ho
DH
Jung
Sung Soo
SS
Yoo
Dae Hyun
DH
Kim
Seong Yoon
SY
Choe
Gheeyoung
G
Kim
Tae Hwan
TH
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood; D018826:CD13 Antigens / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D017285:Polymyositis / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D016898:Interferon-alpha; D001219:Aspartate Aminotransferases; D018826:CD13 Antigens