만성 C형 간염 환자에서 Interferon-${\alpha}$를 투여중 발생한 간질성 폐렴 1예

A Case of Interstitial Pneumonitis developed by Interferon-${\alpha}$ Treatment for Chronic Hepatitis C

만성 C형 간염환자에서 IFN으로 치료중에 발생된 간질성 폐렴은 매우 드물고 아직까지국내에는 보고된 바 없었다. 저자들은 만성 C형 간염환자가 IFN-${\alpha}$를 투여받던 중에 기침과 호흡곤란을 주소로 내원하여 간질성 폐렴으로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Interstitial pneumonitis associated with interferon alpha therapy for chronic hepatitis C was first describe6 in 1994 by Kazoo et al In Japan. The mechanism of interstitial pneumonitis developed by interferon alpha was still unknown but immunologic, allergic of direct lung toxicity were suggested. We experienced a case of interstitial pneumonitis developed during interferon alpha therapy for chronic hepatitis C in a 52-year-old male patient. He was treated with 6 million units of interferon alpha intramuscularly 3 times per week for 4 weeks and noted progressive dyspnea and cough. These symptoms were subsided after 6 weeks' discontinuation of interferon alpha therapy. And so, he was retreated with 3 million units of interferon alpha 3 times per week for 8 weeks and felt dyspnea again. He was admitted to our hospital for further evaluation of progressive dyspnea. Arterial blood gas(ABG) values were $PaO_2$ 90.7 mmHg and $PaCO_2$ 31.9 mmHg, and antinuclear antibody(ANA) was negative. A chest X-ray film revealed diffuse reticulo-nodular shadows in bilateral lung fields, suggesting a diagnosis of interstitial pneumonitis. A marked increase in lymphocyte count and suppressor T cell were observed in bronchoalveolar lavage(BAL) fluid. Lymphocyte stimulation test with interferon alpha was positive. Interstitial pneumonitis was confirmed by transbronchial lung biopsy. After discontinuation of interferon alpha, we gave oral steroid in the condition that clinical symptoms were being improved gradually.