Severe stomatitis complicating treatment with pegylated-interferon alpha-2a and ribavirin in an HCV-infected patient.
OBJECTIVE
To report a case of severe stomatitis probably induced by peginterferon alpha-2a.


RESULTS
A 42-year-old man with chronic hepatitis C genotype 1b commenced treatment with peginterferon alpha-2a 180 microg subcutaneously weekly and ribavirin 1000 mg/d orally. Twenty-eight days after commencing treatment, the patient experienced difficulties with swallowing, dryness of the mouth, stomatitis, and pain. Diagnosis of stomatitis was made. He did not complain of any other adverse effect of peginterferon alpha-2a and ribavirin. Both medications were discontinued. The withdrawal of peginterferon alpha-2a was followed by the resolution of the oral lesions in three weeks. The patient was followed up in the outpatient clinic at one month and at three months, and he was asymptomatic.


CONCLUSIONS
Manufacturers of peginterferon alpha-2a suggest that mouth ulceration, stomatitis, dysphagia, and glossitis are considered adverse reactions of this medication. In this case, the most likely cause of the stomatitis was considered to be peginterferon alpha-2a because of the close temporal relationship between exposure to the drug and onset of symptoms, as well as the rapid resolution of the symptoms and signs after peginterferon alpha-2a was discontinued. An objective causality assessment revealed that a adverse drug event was possible. Clinicians should be aware of this potentially adverse effect of a widely used drug.
Borrás-Blasco
Joaquín
J
Pharmacy Service, the Gastroenterology Section, Hospital de Sagunto, Valencia, Spain. jborrasb@sefh.es
Primo
J
J
Rosique-Robles
J Dolores
JD
Casterá
Elvira
E
Abad
F Javier
FJ
Jiménez
I
I
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D013280:Stomatitis / Q000139:chemically induced*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a