Carrillo-Esper Raúl, González-Avila Daniela, Uribe-Ríos Marittza, Méndez-Sánchez Nahum
Intensive Care Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
Ann Hepatol. 2008 Jan-Mar;7(1):87-90.
Since 2004, pegylated interferon (P-IFN) in combination with ribavirin has become the optimal choice of therapy for chronic hepatitis C virus (HCV) infection. IFN a-2b suppresses HCV replication and restores elevated serum aminotransferase levels, leading to improvements in the histological changes in the livers of patients with chronic hepatitis C. Unfortunately, P-IFN has several adverse effects, including pneumonitis. This complication has been reported in the treatment of malignant diseases and CHC. We report a patient with interstitial pneumonitis thought to be caused by an IFN-based treatment in an unusual scenario of a patient with HCV-related Child-Pugh stage A cirrhosis, who experienced dyspnea, fever, and cough after 12 months of treatment with P-IFN a-2b. Her lung injury and pulmonary symptoms did not disappear despite discontinuation of IFN and the administration of corticosteroid. We concluded that the patient developed a fatal interstitial pneumonitis associated with P-INF a-2b therapy.
自2004年以来,聚乙二醇化干扰素(P-IFN)联合利巴韦林已成为慢性丙型肝炎病毒(HCV)感染治疗的最佳选择。干扰素α-2b可抑制HCV复制并使升高的血清转氨酶水平恢复正常,从而改善慢性丙型肝炎患者肝脏的组织学变化。不幸的是,P-IFN有多种不良反应,包括肺炎。这种并发症在恶性疾病和慢性丙型肝炎的治疗中均有报道。我们报告了1例间质性肺炎患者,该患者患有HCV相关的Child-Pugh A级肝硬化,在接受P-IFNα-2b治疗12个月后出现呼吸困难、发热和咳嗽,推测间质性肺炎由基于干扰素的治疗引起。尽管停用了干扰素并给予了皮质类固醇治疗,但其肺损伤和肺部症状仍未消失。我们得出结论,该患者发生了与P-IFNα-2b治疗相关的致命性间质性肺炎。