PDF(Pubmed)
Abstract：
BACKGROUND: Pegylated interferon-alpha (PEG-IFN-α) is available for the treatment of hepatitis B virus infection, which is better than interferon-alpha (IFN-α) for the inhibition of hepatitis B virus replication. Ischemic colitis has been described from non-pegylated IFN-α, which occurs mainly in patients with hepatitis C virus infection. This is the first case of ischemic colitis during pegylated IFN-α monotherapy for chronic hepatitis B.
METHODS: A 35-year-old Chinese man presented with complaints of acute lower abdominal pain and haematochezia, who was receiving PEG-IFN-α-2a monotherapy for chronic hepatitis B.
METHODS: Colonoscopy revealed scattered ulcers and severe mucosal inflammation with edema in the left hemi colon and necrotizing changes in the descending portion. Biopsies revealed focal mucosal chronic inflammation and mucosal erosion. Therefore, the patient was diagnosed with ischemic colitis based on clinical and testing results.
METHODS: PEG-IFN-α therapy was discontinued and switched to symptomatic management.
RESULTS: The patient was discharged from the hospital after recovery. Follow-up colonoscopy revealed normal. The temporal association between the resolution of ischemic colitis and cessation of PEG-IFN-α treatment strongly favors the diagnosis of interferon-induced ischemic colitis.
CONCLUSIONS: Ischaemic colitis is a severe emergency complication of interferon therapy. Physicians should consider this complication in any patient taking PEG-IFN-α who develops abdominal discomfort and hematochezia.
METHODS: A 35-year-old Chinese man presented with complaints of acute lower abdominal pain and haematochezia, who was receiving PEG-IFN-α-2a monotherapy for chronic hepatitis B.
METHODS: Colonoscopy revealed scattered ulcers and severe mucosal inflammation with edema in the left hemi colon and necrotizing changes in the descending portion. Biopsies revealed focal mucosal chronic inflammation and mucosal erosion. Therefore, the patient was diagnosed with ischemic colitis based on clinical and testing results.
METHODS: PEG-IFN-α therapy was discontinued and switched to symptomatic management.
RESULTS: The patient was discharged from the hospital after recovery. Follow-up colonoscopy revealed normal. The temporal association between the resolution of ischemic colitis and cessation of PEG-IFN-α treatment strongly favors the diagnosis of interferon-induced ischemic colitis.
CONCLUSIONS: Ischaemic colitis is a severe emergency complication of interferon therapy. Physicians should consider this complication in any patient taking PEG-IFN-α who develops abdominal discomfort and hematochezia.
摘要：
背景：聚乙二醇干扰素-α（PEG-IFN-α）可用于治疗乙型肝炎病毒感染，对于抑制乙型肝炎病毒复制，比干扰素-α（IFN-α）更好。已经从非聚乙二醇化的IFN-α描述了缺血性结肠炎，主要发生在丙型肝炎病毒感染患者身上。这是在聚乙二醇干扰素-α单药治疗慢性乙型肝炎期间发生的第一例缺血性结肠炎。
方法：一名35岁的中国男子出现急性下腹痛和便血的主诉，正在接受PEG-IFN-α-2a单药治疗慢性乙型肝炎的患者。
方法：结肠镜检查显示，左半结肠有分散的溃疡和严重的粘膜炎症，水肿和下降部分的坏死性改变。活检显示局灶性粘膜慢性炎症和粘膜糜烂。因此,根据临床和检测结果，患者被诊断为缺血性结肠炎。
方法：停止PEG-IFN-α治疗，改用对症治疗。
结果：患者康复后出院。随访结肠镜检查显示正常。缺血性结肠炎的消退和停止PEG-IFN-α治疗之间的时间关联强烈有利于干扰素诱导的缺血性结肠炎的诊断。
结论：缺血性结肠炎是干扰素治疗的严重紧急并发症。医师应在任何服用PEG-IFN-α的患者中考虑这种并发症，这些患者会出现腹部不适和便血。
方法：一名35岁的中国男子出现急性下腹痛和便血的主诉，正在接受PEG-IFN-α-2a单药治疗慢性乙型肝炎的患者。
方法：结肠镜检查显示，左半结肠有分散的溃疡和严重的粘膜炎症，水肿和下降部分的坏死性改变。活检显示局灶性粘膜慢性炎症和粘膜糜烂。因此,根据临床和检测结果，患者被诊断为缺血性结肠炎。
方法：停止PEG-IFN-α治疗，改用对症治疗。
结果：患者康复后出院。随访结肠镜检查显示正常。缺血性结肠炎的消退和停止PEG-IFN-α治疗之间的时间关联强烈有利于干扰素诱导的缺血性结肠炎的诊断。
结论：缺血性结肠炎是干扰素治疗的严重紧急并发症。医师应在任何服用PEG-IFN-α的患者中考虑这种并发症，这些患者会出现腹部不适和便血。
