Details

Autor(en) / Beteiligte

• Höftberger, R.
• Garzuly, F.
• Dienes, H.P.
• Grubits, J.
• Rohonyi, B.
• Fischer, G.
• Hanzely, Z.
• Lassmann, H.
• Budka, H.

Titel

Fulminant central nervous system demyelination associated with interferon-α therapy and hepatitis C virus infection

Ist Teil von

• Multiple sclerosis, 2007-11, Vol.13 (9), p.1100-1106

Ort / Verlag

London, England: SAGE Publications

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• Hepatitis C virus (HCV) infection is common in the general population and may coincide with disease in the central and peripheral nervous system. Interferon-α (IFN-α) is used as treatment for HCV infection. The therapeutic benefit is assumed to result from activation of natural killer cells and CD8+ T cells. Despite its beneficial effects, it has been associated with a number of autoimmune disorders, such as chronic inflammatory demyelinating polyneuropathy and multiple sclerosis. Several clinical reports including magnetic resonance imaging exist, but neuropathological confirmation of MS associated with IFN-α therapy and HCV infection is lacking. We report a case of a female patient with chronic HCV infection who developed `acute MS'-like demyelinating disease after IFN-α administration, with extensive lesions throughout brain and thoracic spinal cord. The patient died after a disease duration of 6 months. Brain autopsy revealed Baló-like demyelinating plaques with positive HCV sequences within florid lesions. The development of fulminant demyelinating disease after administration of IFN-α suggests that autoimmune mechanisms such as T cell mediated tissue damage might be initiated or aggravated by IFN-α therapy. Additionally, the presence of HCV RNA within the demyelinated lesion indicates a possible role in triggering or propagating disease. Multiple Sclerosis 2007; 13: 1100—1106. http://msj.sagepub.com