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Digital ischemic necrosis caused by pegylated interferon in a patient with hepatitis C
Jana G Hashash1, Sean A Tackett, David J McAdams
1Jana G Hashash, Sean A Tackett, David J McAdams, Department of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
Abstract:
Pegylated interferon plus ribavirin remains the first-line treatment for patients with hepatitis C virus (HCV). Interferon α has the most extensive clinical application and is used for the treatment of chronic hepatitis B virus and hepatitis D virus as well as acute and chronic HCV infections. The attachment of polyethylene glycol to interferon increases its half-life by reducing the rate of absorption after injection, reducing renal and cellular clearance and also decreasing immunogenicity. In this case report, we have described a patient with chronic hepatitis C who developed ischemic necrosis of her fingertips after completing her third course of pegylated interferon and ribavirin. The patient underwent a very extensive workup in order to determine the underlying cause of her digital ischemia which was finally determined to be secondary to the use of pegylated interferon.
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