Serum KL-6 Level is Elevated in Chronic Hepatitis C Patients with Combination Therapy of Pegylated Interferon and Ribavirin

Arase, Yasuji; Ikeda, Kenji; Suzuki, Yoshiyuki; Kobayashi, Masahiro; Suzuki, Fumitaka; Akuta, Norio; Sezaki, Hitomi; Hosaka, Tetsuya; Yatsuji, Hiromi; Kawamura, Yusuke; Kobayashi, Mariko; Kumada, Hiromitsu

doi:10.2169/internalmedicine.46.0150

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…In such cases, measurement of KL-6 is useful. KL-6 is produced by type II alveolar epithelial cells in the lung and reflects the extent of pulmonary inflammation and fibrosis [12]. In this patient, the KL-6 level also increased soon after UDCA administration was started, which enabled early diagnosis of interstitial pneumonia.…”

Section: Discussionmentioning

confidence: 63%

Ursodeoxycholic acid exacerbates peginterferon-induced interstitial pneumonia in a patient with hepatitis C

Kaneko

Ogawa

Iwata

et al. 2009

Clin J Gastroenterol

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Pegylated interferon alpha combined with ribavirin is currently the standard treatment for hepatitis C virus (HCV) infection. Ursodeoxycholic acid (UDCA) is used as a complementary treatment in patients who are non-responders or who develop severe side effects of this combined therapy. UDCA is generally considered to be a relatively safe drug. However, we recently encountered a patient with chronic hepatitis C in whom interferon-induced interstitial pneumonia was exacerbated by UDCA. This patient responded to initial antiviral therapy with non-pegylated interferon alpha-2b and ribavirin, but hepatitis recurred soon after the end of treatment. A second course of antiviral therapy using peginterferon alpha-2b and ribavirin achieved normalization of serum transaminases and HCV-RNA, but also caused interstitial pneumonia. After discontinuing peginterferon, this side effect was ameliorated. On the other hand, hepatitis relapsed four months later. UDCA treatment was started and serum transaminase levels decreased, but exacerbation of interstitial pneumonia occurred with marked elevation of the serum KL-6 level. To our knowledge, this is the first reported case of peginterferon-induced interstitial pneumonia showing exacerbation due to UDCA therapy.

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Section: Discussionmentioning

confidence: 63%

Ursodeoxycholic acid exacerbates peginterferon-induced interstitial pneumonia in a patient with hepatitis C

Kaneko

Ogawa

Iwata

et al. 2009

Clin J Gastroenterol

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“…Serum KL‐6 is a sensitive marker of disease activity in fibrosing lung disorders 2,3 . It was reported that KL‐6 levels gradually increased from pretreatment levels when retrospectively measured every 12 weeks during a 48‐week treatment course in chronic hepatitis C patients treated with PEG IFN and RBV therapy, 20 although no patients developed IP in the cohort. Nonetheless, changes in serum KL‐6 may provide useful information to assess early suspicions of IP, especially if accompanied by other diagnostic findings such as clinical examination or CT.…”

Section: Discussionmentioning

confidence: 99%

Early detection of interstitial pneumonia by monitoring KL‐6 in a chronic hepatitis C patient undergoing pegylated interferon and ribavirin therapy

Ichikawa-Yamada¹,

Joshita²,

Tsukahara³

et al. 2011

Hepatology Research

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A 58-year-old woman with chronic hepatitis C developed interstitial pneumonia (IP) while undergoing pegylated interferon (Peg-IFN) α2a and ribavirin (RBV) therapy. Serum levels of sialylated carbohydrate antigen KL-6 (KL-6), a known marker of disease activity in fibrosing lung disorders, had been regularly measured once a month for early detection of IP, and had begun rising noticeably from 12 weeks to 540 U/ml at 33 weeks of treatment. On examination, remarkable fine crackles were detected by dorsal auscultation and bilateral ground glass opacities and reticular shadows were depicted by computed tomography. The patient successfully recovered from her early stage pneumonia by immediate discontinuation of therapy, which indicates that regular monitoring of serum KL-6 may be effective for avoidance of IP progression induced by Peg-IFN and RBV therapy.

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Serum KL-6 Level is Elevated in Chronic Hepatitis C Patients with Combination Therapy of Pegylated Interferon and Ribavirin

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Cited by 2 publications

References 23 publications

Ursodeoxycholic acid exacerbates peginterferon-induced interstitial pneumonia in a patient with hepatitis C

Ursodeoxycholic acid exacerbates peginterferon-induced interstitial pneumonia in a patient with hepatitis C

Early detection of interstitial pneumonia by monitoring KL‐6 in a chronic hepatitis C patient undergoing pegylated interferon and ribavirin therapy

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