Lupus activation with cerebritis following pegylated interferon in a hemodialysis patient.
BACKGROUND
A 20-year-old female patient with chronic hepatitis C virus infection and end-stage renal disease due to systemic lupus erythematosus was admitted to hospital with fever, pain in the abdomen, seizures and an alteration of consciousness. The patient was on maintenance dialysis and was receiving pegylated interferon monotherapy for her chronic hepatitis C virus infection.


METHODS
Physical examination, laboratory tests including complete blood count and measurement of serum electrolyte levels, CT scans of the head and abdomen, MRI of the brain, microscopic examination of the cerebrospinal fluid, chest X-ray, echocardiography and measurement of C3 complement and anti-double-stranded DNA antibody levels.


METHODS
Activation of systemic lupus erythematosus with cerebritis following pegylated interferon therapy.


RESULTS
Intravenous fluid, intermittent oxygen, intravenous diphenylhydantoin, intravenous pulse methylprednisolone 500 mg for 3 days followed by 40 mg per day of oral prednisolone, and temporary withdrawal of pegylated interferon.
Agarwal
Sanjay Kumar
SK
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India. skagarwal58@yahoo.co.in
Lal
Charanjeet
C
Zaidi
Sabahat Husain
SH
D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects*; D004660:Encephalitis / Q000139:chemically induced*; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced*; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins; D006435:Renal Dialysis; D055815:Young Adult
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a