Neurologic toxicity associated with interferon α therapy for renal cell carcinoma

Abstract

A 67-year-old man received interferon α (IFN α ) therapy for lung metastases of renal cell carcinoma (RCC). Multiple pulmonary metastases disappeared completely. However, neurological toxicity was detected by magnetic resonance imaging (MRI) as abnormal brain lesions. After discontinuation of IFN α therapy, his neurological symptoms and abnormal lesions on MRI disappeared completely. Complete remission of RCC has continued, and results of neurological study have remained normal for 5 years after discontinuation of IFN α therapy.

Changes in the NMR Metabolic Profile of Live Human Neuron-Like SH-SY5Y Cells Exposed to Interferon-α2

“…It is now widely accepted that cortical and subcortical brain regions, and neurons, represent important targets of IFN-α, as also demonstrated by brain imaging techniques (Capuron et al 2005(Capuron et al , 2012Daducci et al 2014;Wada et al 2006). Indeed, neurons can be both type I IFN producers and IFN responding cells (Paul et al 2007).…”

Interferon-induced parkinsonism in a patient with chronic hepatitis C

“…The IFN-1 family consists of two distinct groups of proteins designated IFN-α and IFN-β 16 . The former is used to treat various infectious diseases, such as hepatitis C, as well as tumors and leukemia 7,12,13 . The association between IFN-α use and Parkinsonism was first described by Mizoi et al 12 in 1997.…”

“…Data in the literature suggest that the average time for the appearance of Parkinsonism symptoms is variable and can be as long as 30 weeks after the initiation of therapy with interferon [12][13][14][15] . In all reported cases, the Parkinsonism symptoms persisted after discontinuation of interferon and there was partial improvement after treatment with levodopa, indicating a need for continued pharmacological treatment, as in our case.…”

“…Interferons are naturally occurring cytokines that have antiviral, immunomodulatory and antiproliferative effects 9,12,13,16 . The IFN-1 family consists of two distinct groups of proteins designated IFN-α and IFN-β 16 .…”

“…The use of interferon has been associated with many neuropsychiatric complications, such as fatigue, confusional state, seizures, depression and even risk of suicidal ideation 8,9 . In recent years, it has emerged that patients treated with IFN-α or Peg-IFN can present rare neurological motor complications, such as dystonia, myorhythmia, chorea and Parkinsonism syndrome [9][10][11][12][13][14][15] . There have been few reported cases of Parkinsonism in hepatitis C patients treated with interferon, and there is therefore a need to clarify the treatment options in such cases.…”