慢性C型肝炎に対するインターフェロン治療中に急性心筋炎を発症した1例

A Case of Acute Myocarditis during alpha-lnterferon Therapy for Chronic Hepatitis C

　症例は54歳，男性．慢性活動性C型肝炎に対しIFNαで治療中に発熱が持続し，右脚ブロックと心筋逸脱酵素の上昇がみられ入院した．入院第3病日に3度房室ブロックとなり，体外ペースメーカを挿入し救命した．心筋生検では炎症細胞浸潤と心筋に変性壊死像がみられ急性心筋炎と診断した．今後，心筋炎の治療にIFNが用いられる可能性があるが，心毒性を考慮したうえでの慎重投与が望まれる．

A 54-year-old man was admitted to our hospital because of fever, right bundle branch block and an increase in myocardial enzymes during alpha-interferon (IFN) therapy for chronic active hepatitis C. On the third hospital day, third-degree atrioventricular block occurred, so a temporary pacemaker was inserted. Histological specimens obtained by endomyocardial biopsy showed mononuclear cell infiltration adjacent to necrotic and degenerating myocytes, which led to a diagnosis of acute myocarditis. Although it is expected that IFN will become available for clinical use in treat-ing myocarditis, we wish to express our concern about the potential cardiac toxicity of IFN therapy.