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聚乙二醇化干扰素α-2b引发慢性乙型肝炎患者的溃疡性结肠炎:一例报告及文献综述

Ulcerative colitis triggered by pegylated interferon alpha-2b in a patient with chronic hepatitis B: A case report and literature review.

作者信息

Mo Zhishuo, Tang Jian, Wu Zeqian, Chen Dabiao, Xie Dongying, Wang Peipei

机构信息

Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Liver Res. 2021 Apr 20;5(2):97-101. doi: 10.1016/j.livres.2021.04.001. eCollection 2021 Jun.

Abstract

Interferon (IFN) is a multifaceted immunomodulator that is effective against many diseases, including chronic hepatitis B and chronic hepatitis C infection. IFN defends against viral infection, but may also cause various side effects, such as ulcerative colitis (UC). Herein, we present a case of UC triggered by pegylated interferon alpha-2b (PEG-IFN-α-2b) therapy in a patient with concurrent chronic hepatitis B (CHB) infection. The diagnosis was based on typical clinical symptoms, colonoscopy findings, colonic mucosal biopsy, and histopathology. Accordingly, treatment with mesalazine was initiated without stopping PEG-IFN-α-2b. Fortunately, UC relieved gradually without compromising the effects of treatment. Simultaneously, we conducted a literature review of previously published case reports on the side effect of UC in patients with underlying chronic hepatitis. Various reactions have been reported, including induction, exacerbation, and no change. This is the first report of UC triggered by PEG-IFN-α-2b in a CHB patient. We recommend that physicians pay attention to the rare side effect of UC during administration of PEG-IFN-α-2b. Mesalazine can relieve UC with sustained use of PEG-IFN-α-2b.

摘要

干扰素(IFN)是一种多方面的免疫调节剂,对包括慢性乙型肝炎和慢性丙型肝炎感染在内的多种疾病有效。干扰素可抵御病毒感染,但也可能引起各种副作用,如溃疡性结肠炎(UC)。在此,我们报告一例在同时患有慢性乙型肝炎(CHB)感染的患者中,聚乙二醇化干扰素α-2b(PEG-IFN-α-2b)治疗引发UC的病例。诊断基于典型的临床症状、结肠镜检查结果、结肠黏膜活检及组织病理学。因此,在不停用PEG-IFN-α-2b的情况下开始使用美沙拉嗪治疗。幸运的是,UC逐渐缓解,且未影响治疗效果。同时,我们对先前发表的关于慢性肝炎患者发生UC副作用的病例报告进行了文献综述。已报道了各种反应,包括诱发、加重和无变化。这是PEG-IFN-α-2b引发CHB患者UC的首例报告。我们建议医生在使用PEG-IFN-α-2b期间注意UC这种罕见的副作用。持续使用PEG-IFN-α-2b时,美沙拉嗪可缓解UC。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fcf/11791849/034b0769a227/gr1.jpg

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