Interferons
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Interferons
Focal segmental glomerulosclerosis (first report for interferon-γ, interferon-β-1a and interferonβ-1b): 11 case reports Seven women and four men aged 27-69 years [see table] developed collapsing focal segmental glomerulosclerosis (FSGS) during interferon therapy*. Patients had been receiving interferons for between 2 and 48 months when FSGS was diagnosed. SC interferonα had been administered at 3MU thrice weekly in patients with hepatitis C virus (HCV) infection, and 5 days of 20 MU/m2 for4 consecutive weeks followed by 10 MU/m2 thrice weekly for malignant melanoma. Interferon-β-1a was given IM 30 µg/week or SC 22-44µg thrice weekly, while SC interferon-β-1b was administered at a dosage of 8MU every second day. Interferon-γ was given SC at 50 µg/m2 thrice weekly. Renal insufficiency was noted in 10 of the 11 patients; other symptoms included hypoalbuminaemia, oedema, microhaematuria and leukocyturia. Interferons were discontinued in 10 patients (patient 7 was lost to follow-up), and treatment also included corticosteroids in six patients. Renal function improved in nine patients, but patient 3 became haemodialysisdependent.
Patient characteristics Patient/sex/ age (y) 1/F/46 2/F/56 3/M/41 4/M/64 5/M/69 6/F/36 7/F/27 8/F/33 9/F/37 10/M/67 11/F/54
Interferon
Indication
Duration (months)
α α α α α α β-1a β-1b β-1a γ γ
HCV HCV HCV HCV HCV MM MS MS MS IPF IPF
4 2.5 3 2 3 5 NS 36 48 18 4
HCV, hepatitis C virus infection; MM, malignant melanoma; MS, multiple sclerosis; IPF, idiopathic pulmonary fibrosis; NS, not stated.
* authors indicated that, to their knowledge, all patients received standard therapeutic dosages. Markowitz GS, et al. Treatment with IFN-alpha,-beta,or-gamma is associated with collapsing focal segmental glomerulosclerosis. Clinical Journal of the American Society of Nephrology 5: 607-615, No. 4, Apr 2010. Available from: URL: http:// 803024068 dx.doi.org/10.2215/cjn.07311009 - USA
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of focal segmental glomerulosclerosis associated with interferon-γ, interferon-β-1a or interferon-β-1b. The WHO ADR database contained seven reports of focal segmental glomerulosclerosis associated with interferon beta-1a, but no reports associated with interferon gamma or interferon beta-1b.
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Reactions 10 Jul 2010 No. 1309
