Marx J, Schwenger V, Blank N, Stremmel W, Encke J
Medizinische Klinik IV für Gastroenterologie und Infektiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany.
Internist (Berl). 2008 Sep;49(9):1120-5. doi: 10.1007/s00108-008-2099-7.
A 29-year-old male patient with chronic hepatitis C infection and interferon alpha therapy in his medical history was admitted to the hospital because of the clinical manifestation of a pulmonary renal syndrome. High titers of proteinase-3-ANCA were detected, while an infectious agent was ruled out. After diagnosis of Wegener's granulomatosis the patient received prednisolone and cyclophosphamide pulse therapy and remission developed rapidly. Chronic hepatitis C infection as well as interferon therapy are frequently associated with autoimmune disorders. We assume that the interferon therapy itself has triggered autoimmune processes resulting in Wegener's granulomatosis in our patient. Thus we recommend to search specifically for autoimmune disorders in the past medical history and if necessary to consider a screening for autoantibodies before starting an interferon therapy. An autoimmune disease should also be taken into account if new symptoms develop under an ongoing interferon alpha therapy.
一名29岁男性患者，有慢性丙型肝炎感染病史且曾接受过α干扰素治疗，因出现肺肾综合征临床表现入院。检测到高滴度的蛋白酶3-抗中性粒细胞胞浆抗体（proteinase-3-ANCA），同时排除了感染因素。诊断为韦格纳肉芽肿后，患者接受了泼尼松龙和环磷酰胺冲击治疗，病情迅速缓解。慢性丙型肝炎感染以及干扰素治疗常与自身免疫性疾病相关。我们推测干扰素治疗本身引发了自身免疫过程，导致该患者发生韦格纳肉芽肿。因此，我们建议在既往病史中特别留意自身免疫性疾病，必要时在开始干扰素治疗前考虑进行自身抗体筛查。如果在持续的α干扰素治疗过程中出现新症状，也应考虑自身免疫性疾病。
