Abducent Nerve Paralysis during Interferon Alpha-2a Therapy in a Case of Chronic Active Hepatitis C.

Shigemitsu, Toshinori; Kajii, Nobuhiro; Omura, Ryosuke; Harada, Toshinori; Okita, Kiwamu

doi:10.2169/internalmedicine.33.637

Cited by 20 publications

(7 citation statements)

References 21 publications

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“…Case reports mention neurological problems such as inflammatory demyelinating polyneuropathy, mononeuropathy multiplex, axonal polyneuropathy and hearing loss, Bell's palsy, abducent nerve paralysis, multiple sclerosis-like disease and myasthenia gravis. The events are considered as autoimmune manifestations induced by IFN-a (see later paragraph) [37][38][39][40][41][42][43][44][45][46][47] . As a consequence of vascular wall thickening, stroke may occur 48 .…”

Section: Acute Toxicitymentioning

confidence: 99%

Side Effects of Interferon-α Therapy

et al. 2005

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Section: Acute Toxicitymentioning

confidence: 99%

Side Effects of Interferon-α Therapy

et al. 2005

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“…described a 59‐year‐old woman with chronic active hepatitis C infection who developed abducent nerve paralysis 3 days after commencing α‐interferon therapy. The paralysis resolved at about 6 weeks after discontinuation of interferon and steroid therapy [ 15]. No reports of Bell’s palsy in association with interferon therapy were identified in our literature search (Medline 1966–99), although one possible case has been reported to the Committee of Safety in Medicine (unpublished observation).…”

Section: Discussionmentioning

confidence: 99%

Bell’s palsy during interferon therapy for chronic hepatitis C infection in patients with haemorrhagic disorders

Ogundipe

Smith

2000

Haemophilia

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Two adult patients with life-long severe haemorrhagic disorders commenced on interferon-alpha2b therapy for chronic hepatitis C infection. Both developed Bell's palsy several weeks after commencing therapy, They were started on steroids and, in addition, the first patient discontinued interferon-alpha2b therapy while the second patient elected to continue with therapy. In both cases facial paralysis improved over the ensuing weeks. Bell's palsy is often idiopathic but has been reported. in association with herpesviruses. It is not a recognised complication of chronic hepatitis B or C infection, or interferon-alpha2b therapy. However, the interferons are associated with numerous adverse reactions including various neuropsychiatric manifestations and neurological syndromes. There are several reports of nerve palsies, including optic tract neuropathy, occurring during interferon therapy, and immune-based mechanisms are thought to play a role in the aetiopathogenesis. No reports of Bell's palsy in association with interferon therapy were identified in our literature search, although one possible case has been reported to the Committee of Safety in Medicine. Although Bell's palsy in our patients may have occurred by chance, a neuropathic effect of interferon-alpha2b on the facial nerve cannot be excluded and we urge physicians using interferons to be aware of this potential side-effect.

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“…Therapy with IFNα has been associated with the presence of systemic side effects, such as flu-like syndrome, arthralgia, platelet reduction, leukopenia (1) , depression, delirium, thyroid disorders (2) and ocular side effects (3)(4)(5)(8)(9)(10)(11) . There are descriptions in the literature (1,4,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) of retinal vascular abnormalities (retinal microvascular changes, presence of cotton-wool spots, intraretinal hemorrhages, retinal detachment) due to this drug.…”

Section: Introductionmentioning

confidence: 99%