Thrombotic microangiopathy induced by long-term interferon-β therapy for multiple sclerosis: a case report

Broughton, Ashley; Cosyns, Jean‐Pierre; Jadoul, Michel

doi:10.5414/cn106523

Cited by 34 publications

(30 citation statements)

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“…For two other cases, the therapy duration was very short (44 days and 2 weeks),25,26 while a hypothesis suggests that the cumulative effects of IFN may result in the development of renal lesions 27. TMA occurred several months or years after starting the treatment with IFN-α,5 whereas other nephropathies are usually diagnosed in the first weeks of treatment.…”

Section: Discussionmentioning

confidence: 99%

Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

Mahe¹,

Meurette²,

Moreau³

et al. 2013

DDDT

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Interferon beta-1a is available as an immunomodulating agent for relapsing forms of multiple sclerosis. Common side effects include flu-like symptoms, asthenia, anorexia, and administration site reaction. Kidney disorders are rarely reported. In this study we describe the case of a woman who has been undergoing treatment with interferon beta-1a for multiple sclerosis for 5 years. She developed a hemolytic-uremic syndrome with intravascular hemolysis in a context of severe hypertension. A kidney biopsy showed a thrombotic microangiopathy. This observation highlights an uncommon side effect of long-term interferon beta-1a therapy. Pathophysiological mechanisms leading to this complication might be explained by the antiangiogenic activity of interferon.

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Section: Discussionmentioning

confidence: 99%

Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

Mahe¹,

Meurette²,

Moreau³

et al. 2013

DDDT

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“…Although Orvain et al reported the case of TTP in an MS patient who was treated with interferon b, the pathological mechanism of whether ADAMTS13 inhibitor (autoantibody) is related or not were unclear in many cases [15]. It is unknown why interferon-induced aHUS had develops after long-term use of the drug in patients, including the patient in our case [7,16]. As a high incidence of TMA in MS patients treated with interferon b from the same manufacturer has been reported, a second factor might be involved in the disease onset [17].…”

Section: Case Reportmentioning

confidence: 77%

Thrombotic microangiopathy caused by interferon β-1b for multiple sclerosis: a case report

et al. 2016

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A 41-year-old man with a history of multiple sclerosis (MS) developed thrombotic microangiopathy after taking interferon b-1b for 10 years. Although the relapse of his MS was well controlled under normal blood pressure, he had persistent nausea, anorexia, gait disturbance and visual disorder 1 month before admission. He showed lethargy and high blood pressure (180/ 102 mmHg). Laboratory test results revealed anemia and thrombocytopenia, elevated LDH and renal dysfunction. Urinary dipstick showed a 2? result for proteinuria and 3? for hematuria. Schizocyte were present and haptoglobin decreased, and we diagnosed him with possible thrombotic microangiopathy (TMA). Magnetic resonance image indicated posterior reversible encephalopathy syndrome (PRES), which could be accelerated by TMA. After discontinuing interferon b-1b, high dose intravenous methylpredonisolone, anti-hypertension therapy and plasma exchange was started. Because a mild decrease in ADAMTS13 activity and absence of ADAMTS 13 inhibitor could not cause thrombotic thrombocytopenic purpura, plasma exchange was stopped. The patient's renal function recovered and PRES resolved, and he was discharged with slightly decrease of visual acuity. We suggest that his TMA was likely caused by interferon b-1b, resulting in PRES in a patient with multiple sclerosis. We report this rare case and also review the literature.

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“…High dosage for weight is a risk factor, and our patient had a low body mass index . There is often a short prodrome of rising blood pressure and declining renal function . Early identification of this adverse effect by clinical monitoring prevents further progression, although renal damage is not fully reversible.…”

mentioning

confidence: 87%

Interferon‐beta in multiple sclerosis causing thrombotic microangiopathy

Yam

Fok

McLean

et al. 2019

Internal Medicine Journal

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Thrombotic microangiopathy induced by long-term interferon-β therapy for multiple sclerosis: a case report

Cited by 34 publications

References 0 publications

Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

Renal thrombotic microangiopathy caused by interferon beta-1a treatment for multiple sclerosis

Thrombotic microangiopathy caused by interferon β-1b for multiple sclerosis: a case report

Interferon‐beta in multiple sclerosis causing thrombotic microangiopathy

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