Case Report

Simultaneous Occurrence of Pleural Effusion and Interstitial Pneumonitis After Treatment with Pegylated Interferon for Hepatitis C Virus Infection

Authors: Fanpu Ji, MD, PhD, Zhengxiao Li, MD, PhD, Hongan Xue, MD, Layang Liu, MD, Hong Deng, MD

Abstract

Combination of pegylated interferon and ribavirin has been the standard program for hepatitis C virus (HCV) infection. Pulmonary complications, although uncommon, have been reported in association with the use of interferon, and pleural effusion is rare. We report the second case of pleural effusion and interstitial pneumonitis in a patient treated with pegylated interferon and ribavirin for chronic HCV infection. The respiratory symptoms of our patient continued to progress even though the treatment with pegylated interferon had been withdrawn, but the symptoms improved dramatically following treatment with steroids.


Key Points


* Simultaneous occurrence of pleural effusion and interstitial pneumonitis can possibly be induced by pegylated interferon α-2a.


* The overall risk of pulmonary toxicity during the use of pegylated interferon α-2a appears low; clinicians should be aware of these rare reactions.


* Prompt discontinuation of medication is the cornerstone of treatment, and corticosteroid therapy may not be essential for pleural effusion and interstitial pneumonitis after discontinuation of pegylated interferon. Methylprednisolone pulse therapy should be prescribed to patients with progressive pulmonary injury.

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