title: Drug-indiced aseptic meningitis: development of subacute sclerosing panencephalitis following repeated intraventricular infusion therapy with interferon alpha/beta.
abstract: Interferon (IFN)-α was reported to be effective in longterm intrathecal treatment of subacute sclerosing panencephalitis (SSPE). However, the side effects related with longterm use of IFN-α/β are unclear. We evaluated the therapeutic effects of IFN-α/β in a 13-years-old patient with SSPE. The cerebrospinal fluid (CSF) measles antibody titer was 64 × NT/128×HI, IgG-index was 4.5, and the SSPE diagnosis was based on electroencephalography (Jabbour-stage II on admission). With Inosiplex (INP) given orally, IFN-α (3 × 10(6) units) was infused intraventricularly twice-a-week for 1-year. Resultantly, CSF cell count was elevated (2502/3), total protein and glucose levels were normal; however, DIAM occurred repeatedly. Consequently, reduced IFN-α (5 × 10(5) units) with hydrocorton was administered at 2-months interval for 19 months, during which, DIAM occurred four times. Therefore, IFN-β (3 × 10(6) units; twice-a-week) therapy was started and continued for 3 years. Although the symptoms were improved considerably, DIAM recurred after 15-months therapy and CSF cell counts were also elevated (2121/3). Since SSPE progressed to Jabbour-stage IV, indicated by irreversible consciousness disorder, IFN therapy was discontinued and INP monotherapy was followed for another 3 years. We, therefore, concluded that the longterm intraventricular IFN-α/β infusion therapy of SSPE involved the potential risk of DIAM with serious irreversible neurological sequelae and should be monitored carefully.
authors: Department of Pediatrics, Dokkyo Medical University School of Medicine, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan. geo@dokkyomed.ac.jp
authors: George
authors: G
authors: Imataka
authors: Eiji
authors: E
authors: Nakagawa
authors: Hideo
authors: H
authors: Yamanouchi
authors: Osamu
authors: O
authors: Arisaka
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D057967:Infusions, Intraventricular; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects*; D016899:Interferon-beta / Q000008:administration & dosage* / Q000009:adverse effects*; D008582:Meningitis, Aseptic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D013344:Subacute Sclerosing Panencephalitis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D013997:Time Factors
chemical_list: D016898:Interferon-alpha; D016899:Interferon-beta