A case of hearing loss associated with pegylated interferon and ribavirin treatment ameliorated by prednisone

Le, Vu; Bader, Ted; Fazili, Javid

doi:10.1038/ncpgasthep1317

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…15 Rarely other neurological adverse effects of PEG-IFN therapy may include oculomotor nerve paralysis, seizures, Bell's palsy, peripheral neuropathy and acute sensorineural hearing loss. [16][17][18][19] To the best of our knowledge, this is the fi rst case that describes acute sensorineural hearing loss associated with PEG-IFN therapy in Brazil. Several factors may be associated with SHL in patients treated with interferon-alpha.…”

Section: Discussionmentioning

confidence: 85%

Pegylated interferon/ribavirin-associated sudden hearing loss in a patient with chronic hepatitis C in Brazil

Mendes-Corrêa¹,

Bittar²,

Salmito³

et al. 2011

Braz J Infect Dis

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Sudden hearing loss is defined as a sensorineural hearing loss, equal to or greater than 30 dB, at three or more consecutive frequencies, which takes place within 72 hours. Both peginterferon and ribavirin are well-known to be associated with significant adverse effects, but sudden hearing loss is uncommon. We report a 65-year-old male patient who developed sudden-onset hearing loss during combination therapy with pegylated interferon-alpha and ribavirin for chronic hepatitis C. Peginterferon and ribavirin may cause sudden hearing loss that may not recover after discontinuation of therapy. Immediate treatment for all possible etiologies is essential, along with targeted investigations and early referral for an Ear, Nose and Throat specialist. Physicians should be aware of the possible ototoxic effects of peginterferon and ribavirin combination therapy requiring appropriate surveillance

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Section: Discussionmentioning

confidence: 85%

Pegylated interferon/ribavirin-associated sudden hearing loss in a patient with chronic hepatitis C in Brazil

Mendes-Corrêa¹,

Bittar²,

Salmito³

et al. 2011

Braz J Infect Dis

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“…Ayrıca PEG-İFN'a bağlı ani işitme kaybı gelişen bir hastaya 2 hafta 60mg/gün prednizon tedavisi verilmiş, 3 haftada azaltılarak kesilmiştir. Hastada interferon tedavisi 48 haftaya tamamlanmıştır ve ani işitme kaybının düzeldiği bildirilmiştir (16). Bunların dışında PEG-İFN tedavisine bağlı ani işitme kaybının tedavisinde kullanılan farmakolojik tedavi ile ilgili çalışma yoktur.…”

Section: Discussionunclassified

Pegile Interferon Alfa/Ribavirin Tedavisine Bağlı Gelişen Sensorinöral Tipte İşitme Kaybı: Olgu Sunumu

...

2012

Vhd

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Ge liş ta ri hi/Re cei ved:03.09.2012 Ka bul ta ri hi/Ac cep ted:18.10.2012 © Viral Hepatit Dergisi, Ga le nos Ya y› ne vi ta ra f›n dan ba s›l m›fl t›r. / Viral Hepatitis Journal, pub lis hed by Ga le nos Pub lis hing. ABS TRACT The effect of interferon alpha in chronic viral hepatitis and common side effects are well known, but hearing loss have been rarely reported. A 66-yearold woman was administered peg-interferon alpha-2a (180 mcg, one times a week) and ribavirin(1200 mg daily) with the diagnosis of chronic hepatitis C. At the eighth month of the treatment hearing loss developed. The finding of audiometry was sensorineural hearing loss. Our diagnosis sensorineural type hearing loss thought to be a side effect of peg-interferon. In conclusion, the development of sensorineural hearing loss in patient may suggest autoimmunity as the cause of this side effect.

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“…Early onset may indicate hypersensitivity reaction. Most of the patients recover completely on stopping the treatment [1,3,4,6] but permanent hearing loss has also been reported [2,9,10].…”

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confidence: 97%

“…Most of the reported cases have occurred in late stages of treatment [1,4,6,9] though occasional cases have occurred as early as day 1 after starting treatment [2,9,10]. Early onset may indicate hypersensitivity reaction.…”

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confidence: 98%

“…Various hypothesis for ototoxicity associated with interferon therapy are autoimmune (detection of anti-endothelial cell autoantibodies and response to prednisolone) [1,[3][4][5], direct ototoxicity [6], transient ischemia and microvasculature changes. Tunca et al [7] postulated damage to outer hair cells; however Akyol et al [8], reported decreased number of fibroblasts and prominent cytoplasmic vacuolation in mice cochlea with normal hair cells.…”

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confidence: 99%

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Unilateral hearing loss due to pegylated interferon-α2b and ribavirin therapy

Jain

Midha

Sood

2011

Indian J Gastroenterol

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Combination of pegylated interferon and ribavirin is the standard of care in patients with chronic hepatitis C virus infection. However this therapy has many side effects, including flu-like symptoms, neuropsychiatric symptoms and cytopenias. Auditory symptoms like tinnitus and hearing loss have only rarely been reported.A 40-year-old man, incidentally detected to have hepatitis C virus (HCV) infection a year ago, was referred to our hospital for further management. He was asymptomatic and physical examination was unremarkable. Investigations revealed normal complete blood counts, renal function tests, glucose and bilirubin, and elevated alanine aminotransferase (ALT 126 U/L). Anti-HCV was positive, HCV viral load was 4.2×10 6 IU/mL and genotype was 3. Ultrasonography abdomen revealed normal size and echotexture of liver. He was diagnosed to have chronic HCV infection and was started on pegylated interferon α2b 80 μg subcutaneously per week (body weight 62 kg) plus oral ribavirin 800 mg/ day. He used to have fever and flu-like symptoms lasting for 2-3 days after each dose of interferon. Hemoglobin declined by 3 gm/dL by week 12 and he lost 5 kg of weight. His viral load had become negative by week 4 (rapid virological response) and remained negative at week 12 (early virological response). In the 19th week of antiviral therapy, he started having pain in left ear associated with some hearing loss.He denied any history of hearing loss or exposure to any ototoxic drugs in the past. Tympanic membrane did not reveal any abnormality. MRI of the middle ear was normal. Pure tone audiometry showed a profound sensorineural hearing loss of 70/120 dB in his left ear and normal hearing of 18/18 dB in the right ear. The patient decided to discontinue further therapy. At the end of treatment his ALT values were normal and HCV RNA was undetectable.He was prescribed multivitamins and anti-inflammatory drugs. Pain in the left ear decreased but hearing loss showed no improvement over a 6-month follow up. HCV RNA was undetectable indicating sustained virological response.

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A case of hearing loss associated with pegylated interferon and ribavirin treatment ameliorated by prednisone

Abstract: Prednisone while maintaining treatment with PEG-IFN.

Cited by 12 publications

References 16 publications

Pegylated interferon/ribavirin-associated sudden hearing loss in a patient with chronic hepatitis C in Brazil

Pegylated interferon/ribavirin-associated sudden hearing loss in a patient with chronic hepatitis C in Brazil

Pegile Interferon Alfa/Ribavirin Tedavisine Bağlı Gelişen Sensorinöral Tipte İşitme Kaybı: Olgu Sunumu

Unilateral hearing loss due to pegylated interferon-α2b and ribavirin therapy

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