Pegylated interferon alpha-2a-associated life-threatening Evans' syndrome in a patient with chronic hepatitis C.
In this report, we describe an unusual and unreported complication with the new licensed form of pegylated interferon alpha2a (PEG-IFN-alpha2a). We report the first case of severe autoimmune cytopenias, an Evans' syndrome, in a patient with chronic hepatitis C, 2 months after PEG-IFN-alpha2a initiation. Haemolytic anaemia and thrombocytopenia developed, complicated by gastric bleeding and brain haemorrhage. Outcome was favourable under immunosuppressive treatment. Treatment with PEG-IFN-alpha2a requires careful follow-up, as IFNalpha can induce or exacerbate autoimmune diseases.
Lambotte
Olivier
O
Department of Internal Medicine, Kremlin Bicêtre Hospital, AP-HP, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France. olivier.lambotte@bct.ap-hop-paris.fr
Gelu-Simeon
Moana
M
Maigne
Gwenola
G
Kotb
Rami
R
Buffet
Catherine
C
Delfraissy
Jean François
JF
Goujard
Cécile
C
D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology*; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a