Kuwata Akiko, Ohashi Masuo, Sugiyama Masaya, Ueda Ryuzo, Dohi Yasuaki
Second Department of Internal Medicine, Nagoya City University Medical School, Mizuho-ku, Nagoya 467-8601, Japan.
Am J Med Sci. 2002 Dec;324(6):331-4. doi: 10.1097/00000441-200212000-00008.
A 47-year-old man with renal cell carcinoma underwent nephrectomy, and postoperative chemotherapy was performed with recombinant alpha-interferon. Five years later, he experienced dyspnea during physical exertion. An echocardiogram revealed dilatation and systolic dysfunction of the left ventricle, and thallium-201 myocardial scintigraphy showed diffuse heterogeneous perfusion. We diagnosed congestive heart failure because of cardiomyopathy induced by alpha-interferon therapy. Withdrawal of interferon therapy and the combination of an angiotensin-converting enzyme inhibitor, diuretics, and digitalis improved left ventricular systolic function. Furthermore, myocardial scintigraphy using [123I] beta-methyl-p-iodophenylpentadecanoic acid (123I-BMIPP) or [123 I]metaiodobenzylguanidine (123I-MIBG) revealed normal perfusion after the improvement of congestive heart failure. This is a rare case of interferon-induced cardiomyopathy that resulted in normal myocardial images in 123I-BMIPP and 123I-MIBG scintigrams after withdrawal of interferon therapy.
一名47岁的肾细胞癌男性患者接受了肾切除术，并使用重组α干扰素进行术后化疗。五年后，他在体力活动时出现呼吸困难。超声心动图显示左心室扩张和收缩功能障碍，铊-201心肌闪烁显像显示弥漫性不均匀灌注。我们诊断为α干扰素治疗引起的心肌病导致的充血性心力衰竭。停用干扰素治疗并联合使用血管紧张素转换酶抑制剂、利尿剂和洋地黄改善了左心室收缩功能。此外，使用[123I]β-甲基-对-碘苯基十五烷酸（123I-BMIPP）或[123I]间碘苄胍（123I-MIBG）进行的心肌闪烁显像显示，充血性心力衰竭改善后灌注正常。这是一例罕见的干扰素诱导性心肌病病例，在停用干扰素治疗后，123I-BMIPP和123I-MIBG闪烁显像显示心肌图像正常。
