Multiple sclerosis-like disease secondary to alpha interferon.
OBJECTIVE
To describe bilateral optic neuritis that occurred as an adverse effect of recombinant and natural interferon alpha administration.


METHODS
Report of two cases. Case 1, a 62-year-old woman, developed bilateral optic neuritis with decreased sensation of vibration and increased deep tendon reflex in the lower extremities after a seven-month use of recombinant interferon alpha-2a for chronic active hepatitis C. Case 2, a 29-year-old woman, developed bilateral optic neuritis combined with numbness of the lower extremities as well as bowel and bladder dysfunction after a 22-month use of recombinant interferon alpha-2b for chronic myelogenous leukemia. After a two-month interruption of interferon administration, natural interferon alpha was given but followed by another episode of the same neurological manifestations.


RESULTS
In both cases, magnetic resonance imaging demonstrated multiple small high-intensity areas in the cerebral white matter and spinal cord, while cerebrospinal fluid examination disclosed mononuclear cell increase and protein elevation including myelin basic protein, all of which simulated the features of multiple sclerosis. The two patients underwent several courses of pulse corticosteroid therapy, each course consisting of three days of methylprednisolone 1000 mg daily, resulting in visual recovery to some extent.


CONCLUSIONS
Optic neuritis in combination with other neurological signs, simulating multiple sclerosis, should be included in the list of adverse effects of recombinant and natural interferon alpha administration.
Matsuo
Toshihiko
T
Department of Ophthalmology, Okayama University Medical School, Okayama City, Japan. matsuot@cc.okayama-u.ac.jp
Takabatake
Ryu
R
D000328:Adult; D000783:Aneurysm / Q000139:chemically induced / Q000175:diagnosis; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000009:adverse effects*; D005123:Eye / Q000098:blood supply; D005260:Female; D005451:Fluorescein Angiography; D019698:Hepatitis C, Chronic / Q000188:drug therapy; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects*; D016898:Interferon-alpha / Q000009:adverse effects*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000139:chemically induced* / Q000188:drug therapy; D009422:Nervous System Diseases / Q000139:chemically induced; D009902:Optic Neuritis / Q000139:chemically induced* / Q000188:drug therapy; D011994:Recombinant Proteins
D000970:Antineoplastic Agents; D000998:Antiviral Agents; D007370:Interferon Type I; D016898:Interferon-alpha; D011994:Recombinant Proteins