Ji FP, Li ZX, Deng H, Xue HA, Liu Y, Li M. Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C. World J Gastroenterol 2010; 16(35): 4394-4399 [PMID: 20845505 DOI: 10.3748/wjg.v16.i35.4394]
Corresponding Author of This Article
Fan-Pu Ji, MD, PhD, Department of Infectious Diseases, Second Affiliated hospital, College of Medicine, Xi’an Jiaotong University, 157 Xi Wu Road, Xi’an 710004, Shaanxi Province, China. jifanpu1979@163.com
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World J Gastroenterol. Sep 21, 2010; 16(35): 4394-4399 Published online Sep 21, 2010. doi: 10.3748/wjg.v16.i35.4394
Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C
Fan-Pu Ji, Zheng-Xiao Li, Hong Deng, Hong-An Xue, Yuan Liu, Min Li
Fan-Pu Ji, Hong Deng, Hong-An Xue, Department of Infectious Diseases, Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Zheng-Xiao Li, Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Yuan Liu, Department of Pulmonary Medicine, Second Affiliated Hospital, College of Medicine, Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Min Li, Department of Imageology, First Affiliated Hospital, College of Medicine, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: All authors collaborated in the study design; Ji FP and Li ZX contributed equally to this work; Ji FP and Li ZX independently searched the literature and chose the relevant studies; Ji FP, Li ZX, Xue HA, Liu Y and Li M extracted and analyzed the clinical data, evaluated the severity degree of pulmonary functional impairment; Ji FP prepared the first manuscript draft; Li ZX and Deng H modified the manuscript subsequently; all authors approved the manuscript.
Supported by Natural Science Foundation of Shaanxi Province, China, No. 2008K09-05
Correspondence to: Fan-Pu Ji, MD, PhD, Department of Infectious Diseases, Second Affiliated hospital, College of Medicine, Xi’an Jiaotong University, 157 Xi Wu Road, Xi’an 710004, Shaanxi Province, China. jifanpu1979@163.com
Telephone: +86-29-87331497 Fax: +86-29-87679275
Received: April 8, 2010 Revised: May 24, 2010 Accepted: May 31, 2010 Published online: September 21, 2010
Abstract
Interstitial pneumonitis (IP) is an uncommon pulmonary complication associated with interferon (IFN) therapy for chronic hepatitis C virus (HCV) infection. Pneumonitis can occur at any stage of HCV treatment, ranging from 2 to 48 wk, usually in the first 12 wk. Its most common symptoms are dyspnoea, dry cough, fever, fatigue, arthralgia or myalgia, and anorexia, which are reversible in most cases after cessation of IFN therapy with a mean subsequent recovery time of 7.5 wk. Bronchoalveolar lavage in combination with chest high resolution computed tomography has a high diagnostic value. Prompt discontinuation of medication is the cornerstone, and corticosteroid therapy may not be essential for patients with mild-moderate pulmonary functional impairment. The severity of pulmonary injury is associated with the rapid development of IP. We suggest that methylprednisolone pulse therapy followed by low dose prednisolone for a short term is necessary to minimize the risk of fatal pulmonary damage if signs of significant pulmonary toxicity occur in earlier stage. Clinicians should be aware of the potential pulmonary complication related to the drug, so that an early and opportune diagnosis can be made.
