[Multiple mononeuropathy during recombinant interferon-alpha 2a therapy for chronic hepatitis C]

Area of Science:

• Neurology
• Hepatology
• Pharmacology

Background:

• Chronic hepatitis C is often treated with interferon-alpha 2a (IFN-alpha 2a), a biologic agent.
• Interferon therapies can have various side effects, necessitating careful patient monitoring.
• Understanding drug-induced neurological complications is crucial for patient safety and treatment efficacy.

Observation:

• A 38-year-old male developed symptoms of multiple mononeuropathy, including numbness and weakness, during rIFN-alpha 2a treatment for chronic hepatitis C.
• Neurological examination revealed asymmetrical sensory disturbances and motor deficits, particularly in the extremities and upper limbs.
• Electrophysiological studies indicated an axonal form of mononeuropathy with reduced nerve action potential amplitudes.

Findings:

• The patient's symptoms emerged seven weeks into the rIFN-alpha 2a therapy.
• Muscle and nerve biopsies did not reveal significant pathological changes.
• Clinical and electrophysiological abnormalities showed gradual improvement following treatment with methylprednisolone, prednisolone, and mizoribine.

Implications:

• This case suggests a potential causal link between rIFN-alpha 2a administration and the development of axonal multiple mononeuropathy.
• The findings highlight the importance of considering drug-induced neuropathy in patients receiving interferon therapy.
• Prompt recognition and management with immunosuppressive agents may mitigate the severity of interferon-induced neurological complications.