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      Thrombotic microangiopathy associated with use of interferon-beta

      case-report

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          Abstract

          Interferon-beta is widely used for the treatment of relapsing multiple sclerosis. The drug is usually well tolerated, but autoimmune adverse effects, including kidney disease, have been reported. Only a few cases of hemolytic uremic syndrome-thrombotic microangiopathy associated interferon-alpha have been described so far, and even fewer with beta-interferon. We report a patient who developed thrombotic microangiopathy during treatment with interferon-beta and improved after discontinuation and steroid therapy. Complement cascade and antiphospholipid antibodies are investigated. The spectrum of renal diseases associated with interferon-beta treatment is also reviewed.

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          Most cited references29

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          Atypical hemolytic-uremic syndrome.

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            Multiple sclerosis: side effects of interferon beta therapy and their management.

            Article abstract-Interferon beta (IFNbeta) reduces the relapse rate, disease activity as measured by serial MRI scanning, and disease progression of MS. Therapy with IFNbeta may be associated with a number of adverse reactions. Relatively frequent side effects include flu-like symptoms, transient laboratory abnormalities, menstrual disorders, and increased spasticity. Dermal injection site reactions occur after subcutaneous application of IFNbeta-1b and IFNbeta-1a. Possible side effects of IFNbeta include various autoimmune reactions, capillary leak syndrome, anaphylactic shock, thrombotic-thrombocytopenic purpura, insomnia, headache, alopecia, and depression. We discuss the mechanisms and management of the different side effects of IFNbeta.
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              Interferon-alpha and -beta in kidney inflammation.

              Type I interferons, interferon-alpha and interferon-beta, are central regulators of antiviral immunity and autoimmunity, but little is known about their role in renal inflammation. Recent work documents that viral nucleic acids are potent inducers of interferon-alpha and interferon-beta in mesangial cells and glomerular endothelial cells. This review discusses the available evidence on the role of interferon-alpha and interferon-beta in viral nephropathies, in kidney diseases triggered by extrarenal infections, in lupus nephritis, and in other kidney disease entities. Finally, we propose areas of research that may help unravel the roles of type I interferons and interferon-related genes in the renal field.
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                Author and article information

                Journal
                Int J Nephrol Renovasc Dis
                Int J Nephrol Renovasc Dis
                International Journal of Nephrology and Renovascular Disease
                Dove Medical Press
                1178-7058
                2012
                15 June 2012
                : 5
                : 97-100
                Affiliations
                [1 ]Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
                [2 ]Department of Pathology, Hospital Universitario La Paz, Madrid, Spain
                [3 ]Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
                Author notes
                Correspondence: Teresa Olea, Nephrology Department, Hospital Universitario La Paz, Paseo de la Castellana, 261, Madrid 28046, Spain, Tel +34 9 1727 7151, Email tolea.hulp@ 123456salud.madrid.org
                Article
                ijnrd-5-097
                10.2147/IJNRD.S30194
                3399315
                22815645
                bfa7acfe-b81f-4b7e-ba12-bdc179bda9b9
                © 2012 Olea et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Case Report

                Nephrology
                thrombotic microangiopathy hemolytic uremic syndrome,multiple sclerosis,interferon-beta

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