Long-term therapy of interferon-alpha induced pulmonary arterial hypertension with different PDE-5 inhibitors: a case report.
BACKGROUND
Interferon alpha2 is widely used in hepatitis and high-risk melanoma. Interferon-induced pulmonary arterial hypertension as a side effect is rare.


METHODS
We describe a melanoma patient who developed severe pulmonary arterial hypertension 30 months after initiation of adjuvant interferon alpha2b therapy. Discontinuation of interferon did not improve pulmonary arterial hypertension. This patient could be treated successfully with phosphodiesterase-5 inhibitor therapy.


CONCLUSIONS
This is only the 5th case of interferon-induced pulmonary arterial hypertension and the first documented case where pulmonary arterial hypertension was not reversible after termination of interferon alpha2 therapy. If interferon alpha2 treated patients develop respiratory symptoms, pulmonary arterial hypertension should be considered in the differential diagnosis. For these patients phosphodiesterase-5 inhibitors, e.g. sildenafil or vardenafil, could be an effective therapeutic approach.
Jochmann
Nicoline
N
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany. nicoline.jochmann@charite.de
Kiecker
Felix
F
Borges
Adrian C
AC
Hofmann
Maja A
MA
Eddicks
Stephan
S
Sterry
Wolfram
W
Baumann
Gert
G
Trefzer
Uwe
U
D015106:3',5'-Cyclic-GMP Phosphodiesterases; D000328:Adult; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced* / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage*; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008545:Melanoma / Q000188:drug therapy; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage*; D010727:Phosphoric Diester Hydrolases / Q000187:drug effects; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage; D000069058:Vardenafil Dihydrochloride
D007093:Imidazoles; D016898:Interferon-alpha; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068677:Sildenafil Citrate; D010727:Phosphoric Diester Hydrolases; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human