Abstract
A 48-year-old woman developed interstitial pneumonitis while receiving interferon treatment for chronic hepatitis C. Laboratory studies prior to treatment showed elevated serum alanine aminotransferase levels, but chest X-rays and physical examination revealed no abnormalities suggestive of interstitial pneumonitis. At the 9th week of interferon treatment (total dose, 380MU of recombinant interferon-α, without other medications), the patient began to complain of cough and exertional dyspnea. A chest X-ray film revealed diffuse reticulo-nodular shadows in bilateral lung fields, suggesting a diagnosis of interstitial pneumonitis. A marked increase in lymphocyte count was observed in bronchoalveolar lavage fluid and a diagnosis of interstitial pneumonitis was made as a result of transbronchial lung biopsy. Her clinical symptoms and abnormal lung shadows were reversible, improving within a month of the discontinuation of interferon, and disappearing promptly after exogenous corticosteroid was instituted. This may be the first case of drug-induced interstitial pneumonitis occurring during the course of treatment with interferon alone. We should be aware of the possibility of interstitial pneumonitis developing during treatment of chronic hepatitis C with interferon.
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Choo QL, Kuo G, Weiner AJ, et al. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 1989;244:359–362.
Hosoda K, Omata M, Yokosuka O, et al. Non-A, Non-B chronic hepatitis is chronic hepatitis C: A sensitive assay for detection of hepatitis C virus RNA in the liver. Hepatology 1992;15:777–781.
Davis GL, Balart LA, Schiffer ER, et al. The Hepatitis Interventional Therapy Group. Treatment of chronic hepatitis with recombinant interferon alpha: A multicenter randomized, controlled trial. N Engl J Med 1989;321:1501–1506.
Di Bisceglie AM, Martin P, Kassianides C, et al. Recombinant interferon alpha therapy for chronic hepatitis C: A randomized, double-blind, placebo-controlled trial. N Engl J Med 1989;321: 1506–1510.
Iino S, Hino K, Kondo, T, et al. Interferon therapy for non-A, non-B chronic hepatitis. Gastroenterol Jpn 1991; 26:224–229.
Conlon KC, Urba WJ, Smith JW, et al. Exacerbation of symptoms of autoimmune disease in patients receiving alpha-interferon therapy. Cancer 1900;65:2237–2242.
Schultz M, Muller R, von zur Muhlen A et al. Induction of hyperthyroidism by interferon alpha-2b (letter). Lancet 1989;II: 1452.
Papo T, Marcellin P, Bernau J, et al. Autoimmune chronic hepatitis exacerbated by alpha-interferon. Ann Intern Med 1992;116:51–53.
Allen D, Cooper JR, White DA, et al. Drug-induced pulmonary disease. Am Rev Respir Dis 1986;133:321–340.
Crystal RG, Bitterman RB, Rennard SI et al. Interstitial lung disease of unknown cause. Disorders characterized by chronic inflammation of the lower respiratory tract (first of two parts). N Engl J Med 1984;310:154–166.
Shaw RJ, Benedict SH, Clark RAF, et al. Pathogenesis of pulmonary fibrosis in interstitial lung disease. Alveolar macrophage PDGF gene activation and up-regulation by interferon gamma. Am Rev Respir Dis 1991;143:167–173.
Baron S, Dianzani F, Stanton GJ, et al. (eds) The interferon system: A current review to 1987. Ausin: University of Texas Press, 1987.
Ueda T, Ohta K, Suzuki N, et al. Idiopathic pulmonary fibrosis and high prevalence of serum antibodies to hepatitis C virus. Am Rev Respir Dis 1992:146:266–268.
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Moriya, K., Yasuda, K., Koike, K. et al. Induction of interstitial pneumonitis during interferon treatment for chronic hepatitis C. J Gastroenterol 29, 514–517 (1994). https://doi.org/10.1007/BF02361253
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DOI: https://doi.org/10.1007/BF02361253