DOI QR코드

DOI QR Code

C형 간염 환자의 페그인터페론과 리바비린 병합요법 중 발생한 항CCP항체 양성 류마티스 관절염 1예

A Case of Anti-Cyclic Citrullinated Peptide Antibody-Positive Rheumatoid Arthritis Following Peginterferon Alpha-2A and Ribavirin Therapy for Chronic Hepatitis C

  • Kim, Dong-Hyun (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Kim, Young-Hwan (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Lee, Soon-Il (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Ha, Byung-Kil (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Choi, Sung-Ho (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Kim, Sung-Il (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Joung-Wook (Department of Internal Medicine, Busan St. Mary's Medical Center)
  • 발행 : 2012.08.01

초록

만성 C형 간염으로 페그인터페론과 리바비린 병합 치료 시작 16주 후 다발성 관절통이 발생하여, 류마티스관절염 진단하에 NSAID와 DMARD를 투약하여 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Combination therapy with pegylated interferon (IFN) and ribavirin is the mainstay of treatment for chronic hepatitis C. An important side effect of IFN is the induction of an autoimmune disease such as autoimmune thyroid disease or, rarely, rheumatoid arthritis. However, the introduction of pegylated formulations of IFN can minimize the risk of autoimmune induction by reducing immunogenicity. Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies can help distinguish rheumatoid arthritis from hepatitis C-related arthritis. Here, we report the first Korean case of a 48-year-old female who developed anti-CCP antibodypositive rheumatoid arthritis following peginterferon alpha-2a therapy for hepatitis C.

키워드

참고문헌

  1. Kozlowski A, Harris JM. Improvements in protein PEGylation: pegylated interferons for treatment of hepatitis C. J Control Release 2001;72:217-224. https://doi.org/10.1016/S0168-3659(01)00277-2
  2. Harris JM, Chess RB. Effect of pegylation on pharmaceuticals. Nat Rev Drug Discov 2003;2:214-221. https://doi.org/10.1038/nrd1033
  3. Yang D, Arkfeld D, Fong TL. Development of anti-CCPpositive rheumatoid arthritis following pegylated interferon- $\alpha$2a treatment for chronic hepatitis C infection. J Rheumatol 2010;37:1777. https://doi.org/10.3899/jrheum.100092
  4. Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975-982. https://doi.org/10.1056/NEJMoa020047
  5. Choi YY. Role of bone scan in rheumatic diseases. Korean J Nucl Med 2003;37:137-146.
  6. Iannuzzella F, Vaglio A, Garini G. Management of hepatitis C virus-related mixed cryoglobulinemia. Am J Med 2010; 123:400-408. https://doi.org/10.1016/j.amjmed.2009.09.038
  7. Wener MH, Hutchinson K, Morishima C, Gretch DR. Absence of antibodies to cyclic citrullinated peptide in sera of patients with hepatitis C virus infection and cryoglobulinemia. Arthritis Rheum 2004;50:2305-2308. https://doi.org/10.1002/art.20355
  8. Engberg J, Krogsgaard M, Fugger L. Recombinant antibodies with the antigen-specific, MHC restricted specificity of T cells: novel reagents for basic and clinical investigations and immunotherapy. Immunotechnology 1999;4:273-278. https://doi.org/10.1016/S1380-2933(98)00017-7
  9. Moura RA, Cascao R, Perpetuo I, et al. Cytokine pattern in very early rheumatoid arthritis favours B-cell activation and survival. Rheumatology (Oxford) 2011;50:278-282 https://doi.org/10.1093/rheumatology/keq338
  10. Izumi Y, Komori A, Yasunaga Y, et al. Rheumatoid arthritis following a treatment with IFN-alpha/ribavirin against HCV infection. Intern Med 2011;50:1065-1068. https://doi.org/10.2169/internalmedicine.50.4790
  11. Sood A, Midha V, Sood N. Rheumatoid arthritis probably induced by pegylated interferon in a patient with chronic hepatitis C. Indian J Gastroenterol 2004;23:28-29.