title: Dermatomyositis as a complication of interferon-α therapy: a case report and review of the literature.
abstract: Autoimmune disorder is one of the important side effects of interferon-α therapy. Some polymyositis cases as complication of interferon-α therapy were reported, but dermatomyositis were rarely. We report a case of dermatomyositis as a complication of interferon-α therapy for hepatitis C. A 52-year-old Japanese man was treated by combination therapy with pegylated interferon-α-2b and ribavirin for hepatitis C. Three months after the initiation of therapy, he showed erythema in the posterior cervical to dorsal and anterior cervical to thoracic regions, weight loss, general malaise, muscle pain, and severe increase in levels of muscle enzymes. We made a diagnosis of dermatomyositis according to these clinical features, proximal muscle-predominant myogenic change on electromyography, and infiltration of monocytes and CD4+-dominant lymphocytes on skin biopsy, although myositis-associated antibodies were absent. He was successfully treated with intravenous immunoglobulin and tacrolimus in addition to glucocorticoid. This is a very rare case of dermatomyositis associated with interferon-α therapy. We reviewed several similar published cases and the association of dermatomyositis and type I interferon.
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shiba
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Isoda
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kokunai
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Wada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D001706:Biopsy; D003882:Dermatomyositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000009:adverse effects; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b