Passos de Souza E, Evangelista Segundo P T, José F F, Lemaire D, Santiago M
Universidade Federal da Bahia, Salvador, Brazil.
Clin Rheumatol. 2001;20(4):297-9. doi: 10.1007/pl00011206.
Interferon (IFN) therapy has been used for the treatment of common diseases such as hepatitis C, myeloproliferative disorders, autoimmune diseases and various types of cancer. Given the biological properties of interferon, it is not surprising that there are a larger number of side effects due to its use. Although rheumatoid arthritis (RA) is one of the most common autoimmune diseases found in clinical practice, it does not seem to be frequently related to IFN therapy. We report a 40-year-old female patient who, after high doses of IFN-alpha therapy for malignant melanoma, developed symmetrical polyarthritis, with pain and oedema in small and large joints, associated with prolonged morning stiffness. She had positive rheumatoid factor and DR4 HLA phenotype. She was treated with deflazacort (6 mg/day), chloroquine and NSAIDs, with a partial response. In conclusion, although the development of RA after IFN therapy is a rare event, IFN may work as a 'trigger' for such complication, leading to deregulation in the immune cascade in a person genetically predisposed.
干扰素（IFN）疗法已被用于治疗丙型肝炎、骨髓增殖性疾病、自身免疫性疾病和各类癌症等常见疾病。鉴于干扰素的生物学特性，其使用导致大量副作用也就不足为奇了。尽管类风湿性关节炎（RA）是临床实践中最常见的自身免疫性疾病之一，但它似乎与干扰素疗法并不常相关。我们报告一名40岁女性患者，在接受大剂量干扰素α治疗恶性黑色素瘤后，出现对称性多关节炎，大小关节均有疼痛和水肿，并伴有长时间晨僵。她的类风湿因子呈阳性，且具有DR4 HLA表型。她接受了地夫可特（6毫克/天）、氯喹和非甾体抗炎药治疗，有部分疗效。总之，虽然干扰素治疗后发生类风湿性关节炎是罕见事件，但干扰素可能作为这种并发症的“触发因素”，导致具有遗传易感性的个体免疫级联反应失调。
