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Review
. 2010 Sep 21;16(35):4394-9.
doi: 10.3748/wjg.v16.i35.4394.

Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C

Fan-Pu Ji  1 , Zheng-Xiao Li, Hong Deng, Hong-An Xue, Yuan Liu, Min Li
Affiliations
Review

Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C

Fan-Pu Ji et al. World J Gastroenterol. .

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.

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Figures

Figure 1
Figure 1
Chest computed tomography scanning showing symmetrical, bilateral interstitial abnormality with areas of ground glass opacity predominantly involving middle lung fields and lung bases (A), and visible resolution of inflammatory infiltration following symptom improvement with less dyspnoea and cough (B) in 14 out of 21 cases.
Figure 2
Figure 2
Algorithm for the diagnosis and management of interstitial pneumonitis associated with interferon therapy for hepatitis C virus infection. HRCT: High resolution computed tomography; IP: Interstitial pneumonitis.
See this image and copyright information in PMC

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