title: Acute Pancreatitis Associated with Pegylated Interferon and Ribavirin Treatment of Chronic Hepatitis C, Genotype 1b with High Viral Load.
abstract: Acute pancreatitis, an uncommon side effect of pegylated interferon α (PEG-IFN α) and ribavirin (RBV) combination therapy, has rarely been reported in the English language literature. Here, acute pancreatitis associated with PEG-IFN plus RBV treatment is described in three patients with chronic hepatitis C, genotype 1b with high serum hepatitis C virus RNA levels. The patients had been started on weekly subcutaneous injections of PEG-IFN α (60, 80, and 90 μg) plus a daily oral dose of RBV (600 mg). The therapy was discontinued, however, because of the onset of acute pancreatitis (after 15 weeks, 48 weeks, and 3 weeks respectively). The drug-induced pancreatitis was diagnosed on the basis of elevated levels of amylase and lipase and the absence of other identifiable causes. High tumor necrosis factor-α was found in one patient and high interleukin-6 in the other two. The immune system stimulated by PEG-IFN and RBV combination therapy might have caused the acute pancreatitis. Further study is needed to clarify the mechanism of the onset of drug-induced pancreatitis by PEG-IFN and RBV combination therapy.
authors.affiliation: Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nakajima
authors.forename: Keiji
authors.initials: K
authors.lastname: Mita
authors.forename: Katsumi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Miyuki
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Noriko
authors.initials: N
authors.lastname: Sasase
authors.forename: Akira
authors.initials: A
authors.lastname: Muramatsu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi