[Necrotic toes in a female patient using interferon]

Area of Science:

• Neurology
• Immunology
• Vascular Medicine

Background:

• Interferon therapy is a cornerstone treatment for multiple sclerosis (MS), viral hepatitis, and various cancers.
• While beneficial, interferon can induce rare but severe adverse effects, including peripheral vascular complications like ischemia and necrosis.

Observation:

• A case of a 44-year-old woman with relapsing-remitting multiple sclerosis treated with interferon-beta who developed critical ischemia and necrosis of her lower extremity.
• Diagnostic investigations, including extensive laboratory and imaging studies, did not reveal an alternative cause for the vascular complications.

Findings:

• Discontinuation of interferon-beta therapy resulted in rapid and complete healing of the ischemic and necrotic extremity.
• This clinical outcome strongly suggests a direct causal relationship between interferon-beta treatment and the observed vascular complications.

Implications:

• Vascular complications, such as those resembling Raynaud's syndrome, can occur during interferon therapy, potentially years after treatment initiation.
• Early recognition of these symptoms and prompt management, including potential discontinuation of interferon, are crucial to prevent significant patient morbidity.