A case of reversible dilated cardiomyopathy after alpha-interferon therapy in a patient with renal cell carcinoma.
A 47-year-old man with renal cell carcinoma underwent nephrectomy, and postoperative chemotherapy was performed with recombinant alpha-interferon. Five years later, he experienced dyspnea during physical exertion. An echocardiogram revealed dilatation and systolic dysfunction of the left ventricle, and thallium-201 myocardial scintigraphy showed diffuse heterogeneous perfusion. We diagnosed congestive heart failure because of cardiomyopathy induced by alpha-interferon therapy. Withdrawal of interferon therapy and the combination of an angiotensin-converting enzyme inhibitor, diuretics, and digitalis improved left ventricular systolic function. Furthermore, myocardial scintigraphy using [123I] beta-methyl-p-iodophenylpentadecanoic acid (123I-BMIPP) or [123 I]metaiodobenzylguanidine (123I-MIBG) revealed normal perfusion after the improvement of congestive heart failure. This is a rare case of interferon-induced cardiomyopathy that resulted in normal myocardial images in 123I-BMIPP and 123I-MIBG scintigrams after withdrawal of interferon therapy.
Kuwata
Akiko
A
Second Department of Internal Medicine, Nagoya City University Medical School, Mizuho-ku, Nagoya 467-8601, Japan.
Ohashi
Masuo
M
Sugiyama
Masaya
M
Ueda
Ryuzo
R
Dohi
Yasuaki
Y
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D002311:Cardiomyopathy, Dilated / Q000139:chemically induced*; D015897:Comorbidity; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016898:Interferon-alpha