PURPOSE: Hepatitis C is a common infection with worldwide prevalence. The purpose of this abstract is to increase awareness of pulmonary toxicities with the use of Interferon α, as it become increasingly common in the treatment of hepatitis C.
METHODS: We managed two patients with chronic hepatitis C receiving combination therapy with Interferon α and Ribavirin who developed the unusual complication of interstitial pneumonitis. Both middle age, one male and one female. Presenting cardinal symptoms were progressive shortness of breath and dry cough. Also, weigh loss, non-specific chest pain. One patient has ESRD on hemodialysis. No other medication they’re taking had pulmonary toxicities. No significant family history. One patient was former smoker and had history of IVDA. NKDA.On examination they had fever, labor breathing, and hypoxia. Bibasilare crackes on auscultation. CXR showed bilateral patchy infiltrates. PPD was negative. CT chest showed, interstitial infiltrates and adenopathy. VATS were done, showed interstitial pneumonitis, and noncaseating granulomas.
RESULTS: Both patients clinically improved when Interferon α stopped. Follow up CT chest showed improvement, too. Neither patient required corticosteroid.
CONCLUSION: In 1992 Interferon alpha was approved by the FDA for the treatment of chronic viral hepatitis C. Various respiratory complication have been reported with Interferon α such as acute hypersensitivity pneumonitis, subacute cellular interstitial pneumonitis, pulmonary infiltrates and eosinophilia, organising pneumonia with or without bronchiolitis obliterans, bronchospasm, lone cough, pleural effusion, pulmonary hypertension, and pseudo sarcoidosis.The cornerstone of management of interstitial pneumonitis caused by interferon alpha is to stop use of the offending agent. Administering corticosteroids is controversial.
CLINICAL IMPLICATIONS: It is very important for the pumonalogist and gastroenterologist to have knowlege of the various side effects of Interferon alpha, which is increasingly used drug, this will help gastroenterologist for ealy referral, and pulmonalogist to early diagnose and treat those patients.
DISCLOSURE: Haval Saadlla, No Financial Disclosure Information; No Product/Research Disclosure Information