Membranous nephropathy induced by pegylated interferon alpha-2a therapy for chronic viral hepatitis B

Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Clinical nephrology (Impact Factor: 1.13). 06/2012; 77(6):496-500. DOI: 10.5414/CN106903
Source: PubMed


Interferon is used to treat chronic viral hepatitis because of low drug resistance and a high remission rate. However, its propensity to induce and modify autoimmunity has been reported. We used pegylated interferon α-2a to treat a patient with chronic viral hepatitis B. After 5 months of this therapy, the patient developed membranous nephropathy. Complete remission of his nephrotic syndrome was achieved after 1 year of cyclosporine and corticosteroid therapy. During this same period, his chronic viral hepatitis B was controlled by entecavir. To our knowledge, this is the first case in which membranous nephropathy developed during pegylated interferon α-2a therapy for chronic hepatitis B. The autoimmune modulation induced by interferon is the most likely mechanism for this complication.

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    • "Consistent with these effects, an increased prevalence of autoimmune disease is observed when interferon is used to treat diseases like hepatitis B, hepatitis C, or multiple sclerosis . Reports observe that interferon therapy is associated with an increase in autoimmune thyroid disease, type 1 diabetes, membranous nephropathy, and other self-antigeninduced diseases (Mammen et al. 2012; Radhakrishnan et al. 2005; Scavone et al. 2010; Tosone et al. 2007; Tsai et al. 2012). Therapeutically, one would predict that raising the stress response might mitigate the autoimmune destruction of the beta cell. "
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