Severe Agranulocytosis as a Rare Side Effect of Pegylated Interferon Therapy for Chronic Hepatitis B

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Z Gastroenterol. 2011 May;49(5):596-598. Epub 2011 May 9.

Severe Agranulocytosis as a Rare Side Effect of Pegylated Interferon Therapy for

Chronic Hepatitis B.

Zizer E, Bommer M, Barth T, Dikopoulos N.

Source

Internal Medicine I, University of Ulm.

Abstract

We report on a 19-year-old male patient with chronic HBeAg-positive hepatitis

B-infection and agranulocytosis as a severe side effect of pegylated interferon

alpha therapy. Within the first six months of therapy the hepatitis B virus DNA

became undetectable in parallel with a significant decrease of the HBsAg serum

concentration. After a six-month course of therapy the patient was admitted to

our emergency unit. He appeared significantly ill and reported that he had fever

for two days, painful oral mucosa, throat pain and general fatigue and

discomfort. A complete blood cell count was performed and revealed a complete

agranulocytosis with no detectable neutrophilic granulocytes in the blood smear.

Antiviral therapy was immediately stopped and he was admitted to our clinic

where a supportive therapy and an empirical course of broadband antibiotics were

initiated. A few days later an additional treatment with intravenous

prednisolone was started. Within the next week the agranulocytosis resolved and

the neutrophil count was completely restored. In parallel, the clinical status

improved quickly. This case demonstrates the need for our awareness of

agranulocytosis as a rare but severe and potentially life-threatening side

effect of interferon alpha therapy.

© Georg Thieme Verlag KG Stuttgart · New York.

PMID: 21557170 [PubMed - as supplied by publisher]

[Guest guest]

Z Gastroenterol. 2011 May;49(5):596-598. Epub 2011 May 9.

Severe Agranulocytosis as a Rare Side Effect of Pegylated Interferon Therapy for

Chronic Hepatitis B.

Zizer E, Bommer M, Barth T, Dikopoulos N.

Source

Internal Medicine I, University of Ulm.

Abstract

We report on a 19-year-old male patient with chronic HBeAg-positive hepatitis

B-infection and agranulocytosis as a severe side effect of pegylated interferon

alpha therapy. Within the first six months of therapy the hepatitis B virus DNA

became undetectable in parallel with a significant decrease of the HBsAg serum

concentration. After a six-month course of therapy the patient was admitted to

our emergency unit. He appeared significantly ill and reported that he had fever

for two days, painful oral mucosa, throat pain and general fatigue and

discomfort. A complete blood cell count was performed and revealed a complete

agranulocytosis with no detectable neutrophilic granulocytes in the blood smear.

Antiviral therapy was immediately stopped and he was admitted to our clinic

where a supportive therapy and an empirical course of broadband antibiotics were

initiated. A few days later an additional treatment with intravenous

prednisolone was started. Within the next week the agranulocytosis resolved and

the neutrophil count was completely restored. In parallel, the clinical status

improved quickly. This case demonstrates the need for our awareness of

agranulocytosis as a rare but severe and potentially life-threatening side

effect of interferon alpha therapy.

© Georg Thieme Verlag KG Stuttgart · New York.

PMID: 21557170 [PubMed - as supplied by publisher]