Multifocal leukoencephalopathy and polyneuropathy after 18 years on interferon alpha.
Multifocal leukoencephalopathy and sensory-motor polyneuropathy have not been reported as side-effects of long-lasting interferon alpha therapy in a single patient. In a 77-year-old man interferon alpha2b and interferon alpha2a were administered subsequently but continuously since 1984 for hairy cell leukemia. Since early 2000, left-sided hemi-hypesthesia occurred and the patient developed gait disturbance, proximal weakness of the lower limbs, bilateral stocking-type sensory disturbances, and restless leg syndrome. Repeated cerebral magnetic resonance images showed multifocal T2-hyperintense white matter lesions supratentorially. The nerve conduction velocity of the peroneal and sural nerve was reduced. After exclusion of various differential diagnoses of leukoencephalopathy and application of a screening program for polyneuropathy, central and peripheral nervous system abnormalities were attributed to the long-lasting interferon alpha therapy. In single patients abnormally long-lasting interferon alpha therapy may cause multifocal white matter lesions supratentorially and sensory-motor polyneuropathy.
Finsterer
J
J
Neurological Department, KA Rudolfstiftung, Vienna, Austria. duarte@aonmail.at
Sommer
O
O
Stiskal
M
M
D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D007943:Leukemia, Hairy Cell / Q000150:complications / Q000188:drug therapy; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced*; D008279:Magnetic Resonance Imaging; D008297:Male; D011115:Polyneuropathies / Q000139:chemically induced*; D013997:Time Factors
D016898:Interferon-alpha