Interferon alfa granulomatous

Interferon gamma is an activator of macrophages. Its anti-viral activity is limited compared to that of interferon alfa. Human recombinant interferon gamma restores, at least in part, macrophage cytotoxicity and with that decreases the incidence of infections in patients with chronic granulomatous diseases. Its adverse effects consist mainly of flu-like syndrome skin rashes may occur. 

Other adverse liver effects reported with interferon alfa include primary biliary cirrhosis (SEDA-20, 329) and granulomatous hepatitis (SEDA-20, 329) (SEDA-21, 372) (259). 

As with interferon alfa, pegylated interferon alfa has been associated with injection site skin necrosis (285). Severe local reactions after subcutaneous injections mostly consist of ulceration and skin necrosis, but a variety of reactions have been described. Prominent suppuration and granulomatous dermatitis at the injection sites of interferon alfa have been reported in two patients (286). Three patients who had severe rashes while receiving pegylated interferon alfa-2a or 2b had positive intracutaneous tests to both pegylated forms of interferon alfa but not to standard interferon alfa-2a or 2b (287). One of these patients subsequently tolerated standard interferon alfa. Cutaneous ulcers have also been reported in patients treated with peginterferon alfa-2b (288,289). In the latter case, the lesions healed under local therapy and the same dose of interferon was maintained. 

Sanders S, Busam K, Tahan SR, Johnson RA, Sachs D. Granulomatous and suppurative dermatitis at interferon alfa injection sites report of 2 cases. J Am Acad Dermatol 2002 46(4) 611-16. 

Ocular sarcoidosis has been reported in three patients, in two of whom conventional interferon alfa was used and in one peginterferon alfa-2b all had granulomatous panuveitis with choroidal granulomata of various sizes [42 ]. All had also taken ribavirin. The intraocular inflammation was managed by reducing the dose of interferon and all patients received topical glucocorticoids. 

A 56-year-old black woman developed with bilateral orbital swelling in the region of the lacrimal glands after taking interferon-alfa + ribavirin for 4 months for occupationally acquired hepatitis C infection [43 ]. Bilateral lacrimal gland biopsies showed granulomatous inflammation. All other tests were negative for sarcoidosis. 

Recombinant DNA technology products aldesleukin (IL-2, used in renal cancer) erythropoietin (epoetin alfa, used in anemias) filgrastim (G-CSF, used in neutropenia) interferon alpha (used in hepatitis B and C and in cancer), interferon beta (used in multiple sclerosis) interferon gamma (used in chronic granulomatous disease) oprelvekin (IL-11, used in thrombocytopenia) thrombopoietin (used in thrombocytopenia) and sargramostim (GM-CSF, used in neutropenia). 

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