Case Report
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World J Gastrointest Pharmacol Ther. Feb 6, 2011; 2(1): 6-8
Published online Feb 6, 2011. doi: 10.4292/wjgpt.v2.i1.6
Digital ischemic necrosis caused by pegylated interferon in a patient with hepatitis C
Jana G Hashash, Sean A Tackett, David J McAdams
Jana G Hashash, Sean A Tackett, David J McAdams, Department of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States
Author contributions: Hashash JG, Tackett SA and McAdams DJ performed the literature review and wrote the paper.
Correspondence to: Jana G Hashash, MD, Department of General Internal Medicine, University of Pittsburgh Medical Center, 200 Lothrop Street, 826E MUH, Pittsburgh, PA 15213, United States. jhashash@gmail.com
Telephone: +1-412-6924882 Fax: +1-412-6924555
Received: March 24, 2010
Revised: October 1, 2010
Accepted: October 8, 2010
Published online: February 6, 2011
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.

Keywords: Pegylated interferon; Interferon; Hepatitis C; Necrosis; Ischemia