Interferons beta have vasoconstrictive and procoagulant effects: A woman who developed livedo reticularis and Raynaud phenomenon in association with interferon beta treatment for multiple sclerosis

Rot, Uroš; Ledinek, Alenka Horvat

doi:10.1016/j.clineuro.2013.09.027

Cited by 15 publications

(15 citation statements)

References 9 publications

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“…Based on the findings from the right-sided heart catheterization, which confirmed the presence of severe PAH, the patient was immediately started on sildenafil at a dose of 30 mg daily, in line with the current professional literature [1,5,6]. After three months of treatment, the dosage was increased to 60 mg daily, following a bout of respiratory infection with accentuated dyspnea, which had been accompanied by an exacerbation of the patient's MS that had been treated with Solu-Medrol using pulse dosing.…”

Section: Discussionmentioning

confidence: 74%

“…A very similar situation has been described in a case report of a 23-year-old woman treated with interferon beta, who developed PAH after one year of treatment as well; her interferon treatment was discontinued, and she was immediately placed on sildenafil. The patient's further prognosis was favorable [1,2].…”

Section: Discussionmentioning

confidence: 83%

“…Subsequent course of the disease is characterized by an increase in pulmonary vascular resistance, which leads to an elevation of pressure in the pulmonary vascular bed [1]. Normally, mean pulmonary artery pressure (mmHg) is ≤20 mmHg.…”

Section: Introductionmentioning

confidence: 99%

“…First-choice immunomodulatory drugs include interferon beta-1a (Rebif 22 μg and 44 μg and Avonex), interferon beta-1b (Betaferon), and glatiramer acetate (Copaxone)-so far, this has been the only antigen-specific therapy of MS. These first-choice drugs continue to be a fundamental pillar of treatment of patients with clinically isolated syndrome and the relapsing-remitting form of multiple sclerosis [1].…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Arterial Hypertension in a Patient with Multiple Sclerosis Treated with Interferon Beta: A Case Report

Novotná¹

2016

J Neurol Neurosci

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Pulmonary arterial hypertension (PAH) is characterized by elevation of mean pulmonary artery pressure to values conceivably approaching those seen in the systemic vascular bed. This occurrence is associated with a poor prognosis. PAH may result from a variety of causes, some of which are related to pharmacotherapy.Herein, we present a case of a 39-year-old female patient with relapsing-remitting multiple sclerosis (MS), who was receiving immunomodulatory therapy and subsequently developed severe PAH. We presume a causal relationship between the condition and the patient's interferon beta therapy, which had spanned 10 years. The interferon beta therapy was stopped because its continued administration could have led to more rapid progression of severe pulmonary hypertension.Due to the severity of pulmonary arterial hypertension, PAH-specific pharmacotherapy was indicated, using sildenafil. Since 1998, only several cases of pulmonary arterial hypertension in patients treated with interferon beta have been documented in the scientific literature. In some of these instances, including in two case studies involving patients with multiple sclerosis, it was concluded that there was a possible association with this therapy.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pulmonary Arterial Hypertension in a Patient with Multiple Sclerosis Treated with Interferon Beta: A Case Report

Novotná¹

2016

J Neurol Neurosci

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“…Vasoconstrictive and pro-coagulant effects of type I interferon have also been studied in pulmonary arterial hypertension. Experimental models have shown that IFNα increases pulmonary vascular resistance by the activation of thromboxane cascade [62].…”

Section: Discussionmentioning

confidence: 99%

Interferon-Induced Thrombotic Microangiopathy

Kundra¹,

Andrei²,

Wang³

2018

Thrombocytopenia

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Interferon (IFN) is an effective therapy for multiple disorders. An infrequently reported side effect is thrombotic microangiopathy (TMA): thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). We published the first comprehensive review analyzing this association with the following observations: (1) there was a higher incidence of IFN-induced TMA in myeloproliferative disorders (chronic myelogenous leukemia (CML)) than that in nonmalignant disorders (multiple sclerosis (MS), chronic hepatitis C virus infection (HCV)); (2) mean age at diagnosis was 47 years; (3) there was rare association with hairy cell leukemia (HCL), Sezary syndrome (one case each) and no cases reported for polycythemia vera (PV); (4) sex distribution was balanced (exception of higher prevalence in females for MS); (5) TMA was insidious in onset with long incubation periods (average treatment duration 40.4 months); (6) comparative analysis of mean time (months) to onset of TMA ensuing cumulative IFN exposure was: MS 68.6 vs. CML 35.5 vs. HCV 30.4; (7) confirmed TTP (low ADAMTS 13 levels) was associated with the presence of an inhibitor; (8) outcome analysis revealed complete remission in 27 (40%), persistent chronic kidney disease in 28 (42%) and fatality in 12 patients (18%); (9) corticosteroids, plasma exchange (PEX) and rituximab are effective therapies.

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Interferon-β-1b

2014

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Interferons beta have vasoconstrictive and procoagulant effects: A woman who developed livedo reticularis and Raynaud phenomenon in association with interferon beta treatment for multiple sclerosis

Cited by 15 publications

References 9 publications

Pulmonary Arterial Hypertension in a Patient with Multiple Sclerosis Treated with Interferon Beta: A Case Report

Pulmonary Arterial Hypertension in a Patient with Multiple Sclerosis Treated with Interferon Beta: A Case Report

Interferon-Induced Thrombotic Microangiopathy

Interferon-β-1b

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