Life-threatening severe immune thrombocytopenia during alpha-interferon therapy for chronic hepatitis C.
Although mild thrombocytopenia is a common adverse effect of interferon therapy, severe life-threatening thrombocytopenia is extremely rare. Here, we report a case of chronic hepatitis C patient that developed severe thrombocytopenia during alpha-interferon therapy, possibly due to an autoimmune mechanism. A 24-year-old female presented chronic hepatitis C in May, 1998. Based on the clinicopathological findings including a liver biopsy, administration of alpha-interferon was begun. In the fourth week of therapy, she experienced mild dyspnea and general fatigue. Complete blood count demonstrated thrombocytopenia (48,000/microL). Despite the immediate withdrawal of interferon, her platelet count further decreased to 1,100/microL. Bone marrow aspirate and elevated platelet-associated IgG antibodies were suggestive of immune thrombocytopenia. She was treated with intravenous and oral administration of steroids. Her platelet count returned to normal level 5 days later. Response to steroid treatment was consistent with the diagnosis of alpha-interferon-induced immune thrombocytopenia in this patient.
Fujii
Hideki
H
Third Department of Internal Medicine, Osaka City University Medical School, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Japan.
Kitada
Takuya
T
Yamada
Takao
T
Sakaguchi
Hiroki
H
Seki
Shuichi
S
Hino
Masayuki
M
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced* / Q000473:pathology
D000998:Antiviral Agents; D001323:Autoantibodies; D007074:Immunoglobulin G; D016898:Interferon-alpha