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[1例慢性乙型肝炎病毒感染患者接受聚乙二醇化干扰素α-2a治疗后发生慢性炎症性脱髓鞘性多发性神经根神经病]

[A case of chronic inflammatory demyelinating polyradiculoneuropathy after treatment with pegylated interferon α-2a in a patient with chronic hepatitis B virus infection].

作者信息

Naito Hiroyuki, Takeda Ikuko, Segawa Akiko, Tsuge Masataka, Maruyama Hirofumi, Matsumoto Masayasu

机构信息

Department of Neurology, Hiroshima University Hospital.

出版信息

Rinsho Shinkeigaku. 2016 Oct 28;56(10):672-677. doi: 10.5692/clinicalneurol.cn-000888.

Abstract

We report the case of a 42-year-old man with chronic hepatitis B virus infection who developed weakness and paresthesia in the extremities 2 months after administration of pegylated interferon (Peg-IFN)α-2a. Nerve conduction studies conducted 6 months after onset showed abnormal temporal dispersions in both tibial nerves. We diagnosed chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) resulting from treatment with Peg-IFNα-2a. Neurological symptoms were prolonged despite suspension of the treatment. Subsequent treatment with intravenous immunoglobulin improved both clinical symptoms and temporal dispersion. IFNα-induced CIDP is rare, but can reportedly progress even after interruption of IFN-α without immunotherapy. Patients presenting with polyneuropathy after initiation of IFN-α thus require close attention.

摘要

我们报告了一例42岁慢性乙型肝炎病毒感染男性患者,其在使用聚乙二醇化干扰素(Peg-IFN)α-2a治疗2个月后出现四肢无力和感觉异常。发病6个月后进行的神经传导研究显示双侧胫神经存在异常时间离散。我们诊断为Peg-IFNα-2a治疗导致的慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)。尽管停止了治疗,神经症状仍持续存在。随后静脉注射免疫球蛋白治疗改善了临床症状和时间离散。IFNα诱导的CIDP罕见,但据报道即使在中断IFN-α且未进行免疫治疗的情况下仍可能进展。因此,开始使用IFN-α后出现多发性神经病的患者需要密切关注。

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