title: Membranous nephropathy induced by pegylated interferon alpha-2a therapy for chronic viral hepatitis B.
abstract: Interferon is used to treat chronic viral hepatitis because of low drug resistance and a high remission rate. However, its propensity to induce and modify autoimmunity has been reported. We used pegylated interferon α-2a to treat a patient with chronic viral hepatitis B. After 5 months of this therapy, the patient developed membranous nephropathy. Complete remission of his nephrotic syndrome was achieved after 1 year of cyclosporine and corticosteroid therapy. During this same period, his chronic viral hepatitis B was controlled by entecavir. To our knowledge, this is the first case in which membranous nephropathy developed during pegylated interferon α-2a therapy for chronic hepatitis B. The autoimmune modulation induced by interferon is the most likely mechanism for this complication.
authors.affiliation: Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Tsai
authors.forename: Jui-Hao
authors.initials: JH
authors.lastname: Chen
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Fang
authors.forename: An-Hang
authors.initials: AH
authors.lastname: Yang
authors.forename: Chung-Hsin
authors.initials: CH
authors.lastname: Chang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects*; D001706:Biopsy; D016572:Cyclosporine / Q000627:therapeutic use; D057915:Drug Substitution; D015433:Glomerulonephritis, Membranous / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects* / Q000473:pathology; D008297:Male; D009404:Nephrotic Syndrome / Q000139:chemically induced / Q000473:pathology; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D016572:Cyclosporine; C100416:peginterferon alfa-2a