Interstitial pneumonitis after combination therapy with pegylated interferon alpha-2b and ribavirin for chronic hepatitis C.
Pulmonary toxicity is a rare but potentially fatal side effect occurring during interferon (IFN) alpha treatment for chronic hepatitis C. We present a 47-year-old woman who had chronic hepatitis C and was treated with pegylated IFN alpha-2b in combination with ribavirin, with a good virological response by week 10 of therapy. Then the patient began to complain of dyspnea on exertion and a dry cough. A diagnosis of interstitial pneumonitis was made according to the results of chest X-rays, high resolution computed tomography and bronchoalveolar lavage analysis. Pegylated IFN alpha-2b has a longer absorption and elimination half-life than conventional IFN alpha-2b and a comparable potency to conventional IFN alpha-2b. Although the tolerability of pegylated IFN alpha is comparable to that of conventional IFN alpha, pulmonary toxicity may occur more frequently with long-acting pegylated IFN alpha therapy at an inappropriately high dose. Based on a MEDLINE search up to 2004, we believe that this is the first reported case of a patient recovering from interstitial pneumonitis associated with pegylated IFN alpha-2b for chronic hepatitis C. Physicians should keep in mind the possibility of this complication when treating chronic hepatitis C patients with pegylated IFN alpha-2b and ribavirin combinational therapy.
Chen
Yung Che
YC
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Niaosung Shiang, Kaohsiung, Taiwan, R.O.C.
Lu
Sheng-Nan
SN
Lin
Meng-Chih
MC
D000998:Antiviral Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008875:Middle Aged; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b