title: Severe autoimmune hemolytic anemia in a patient with chronic hepatitis C during treatment with peginterferon alfa-2a and ribavirin.
abstract: Peginterferon (Peg-IFN) alfa in combination with ribavirin represents the gold standard treatment for chronic hepatitis C, but is associated with various side effects, especially hematological abnormalities. We report here a case of severe autoimmune hemolytic anemia (AIHA) complicated by symptomatic myocardial ischemia in a patient with chronic hepatitis C during combination therapy. The worsening hemolysis after ribavirin withdrawal and exclusion of other causes implicated Peg-IFN alfa as the cause of AIHA. Our study demonstrates that in patients without preexisting immunological abnormalities Peg-IFN can de novo induce autoimmune complications that, albeit rarely, may be life-threatening.
authors.affiliation: Department of Medical Sciences, University of Cagliari, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Cauli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Serra
authors.forename: Luchino
authors.initials: L
authors.lastname: Chessa
authors.forename: Cinzia
authors.initials: C
authors.lastname: Balestrieri
authors.forename: Rosetta
authors.initials: R
authors.lastname: Scioscia
authors.forename: Maria Eliana
authors.initials: ME
authors.lastname: Lai
authors.forename: Patrizia
authors.initials: P
authors.lastname: Farci
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood / Q000139:chemically induced*; D000998:Antiviral Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006400:Hematocrit; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a