Acute inflammatory demyelinating polyneuropathy associated with pegylated interferon α 2a therapy for chronic hepatitis C virus infection  

作　　者：Vijay Khiani Thomas Kelly Adeel Shibli Donald Jensen Smruti R Mohanty 

机构地区：[1]Department of Medicine, Case Western Reserve University, Cleveland, OH, United States [2]Department of Neurology, The University of Chicago,Chicago, IL, United States [3]Department of Medicine, Weiss Memorial Hospital, Chicago, IL, United States [4]Department of Medicine, Center for Liver Diseases, The University of Chicago, Chicago, IL, United States

出　　处：《World Journal of Gastroenterology》2008年第2期318-321,共4页世界胃肠病学杂志（英文版）

摘　　要：The combination of pegylated interferon (Peg-IFN) and ribavirin is the standard of care for chronic hepatitis C virus (HCV) infection treatment. In general, common side effects related to this combination therapy are mild and are very well tolerated. However, peripheral neuropathy including demyelinating polyneuropathy related to Peg-IFN is extremely rare. We present the first case of an acute inflammatory demyelinating polyneuropathy (AIDP) associated with Peg-IFN-α 2a (Pegasys) after 16 wk of a combination therapy with Pegasys and ribavirin in a 65-year-old woman with chronic HCV infection. She developed tingling, numbness, and weakness of her upper and lower extremities and was hospitalized for acute neurological deficits. Her clinical course, neurological findings, an electromyogram (EMG), nerve conductions studies (NCS), muscle biopsy, and a sural nerve biopsy were all consistent with AIDP likely related to Pegasys use. The patient recovered completely with the use of intravenous immunoglobulin (IVIG) including physical therapy and neurological rehabilitation. It is very important that gastroenterologists and/or hepatologists recognize this rare neurological complication related to Peg-IFN treatment very early, since it requires a prompt discontinuation of therapy including an immediate referral to a neurologist for the confirmation of diagnosis, management, and the prevention of long-term neurological deficits.The combination of pegylated interferon （Peg-IFN） and ribavirin is the standard of care for chronic hepatitis C virus （HCV） infection treatment. In general, common side effects related to this combination therapy are mild and are very well tolerated. However, peripheral neuropathy including demyelinating polyneuropathy related to Peg- IFN is extremely rare. We present the first case of an acute inflammatory demyelinating polyneuropathy （AIDP） associated with Peg-IFN-α 2a （Pegasys） after 16 wk of a combination therapy with Pegasys and ribavirin in a 65-year-old woman with chronic HCV infection. She developed tingling, numbness, and weakness of her upper and lower extremities and was hospitalized for acute neurological deficits. Her clinical course, neurological findings, an electromyogram （EMG）, nerve conductions studies （NCS）, muscle biopsy, and a sural nerve biopsy were all consistent with AIDP likely related to Pegasys use. The patient recovered completely with the use of intravenous immunoglobulin （IVIG） including physical therapy and neurological rehabilitation. It is very important that gastroenterologists and/or hepatologists recognize this rare neurological complication related to Peg-IFN treatment very early, since it requires a prompt discontinuation of therapy including an immediate referral to a neurologist for the confirmation of diagnosis, management, and the prevention of long-term neurological deficits.

关 键 词：NEUROPATHY Pegylated interferon PEGASYS 

分 类 号：R512.63[医药卫生—内科学]