Organizing Pneumonia Associated with Pegylated Interferon α and Ribavirin Therapy

Abstract

Hepatitis C virus infection is the leading cause of chronic liver disease in the United States of America. Pegylated interferon α and ribavirin combination is the mainstay of treatment. Severe pulmonary toxicities are rarely reported. We report here a case of severe form of organizing pneumonia secondary to pegylated interferon α therapy presenting as acute respiratory failure. Patient has near complete recovery with withdrawal of pegylated interferon α and steroid therapy. We report this case to raise the awareness of this rare but potentially life-threatening pulmonary complication of pegylated interferon α therapy.

Figure 1

CXR, frontal view before treatment, showing bilateral interstitial opacities with small lung volume.

Figure 2

CT scan, representative cut showing b/l ground glass opacities with septal thickening from acute lung injury.

Figure 3

Histopathology, focal organizing pneumonia with chronic inflammation and focal fibrinous exudates.

Figure 4

CXR, frontal view after 3 months of steroid therapy with marked improvement in interstitial opacities and residual fibrotic changes.