Rheumatoid Arthritis following a Treatment with IFN-alpha/Ribavirin against HCV Infection

Yasumori Izumi; Atsumasa Komori; Yuki Yasunaga; Satoru Hashimoto; Taiichiro Miyashita; Seigo Abiru; Hiroshi Yatsuhashi; Hiromi Ishibashi; Kiyoshi Migita

doi:10.2169/internalmedicine.50.4790

CASE REPORTS

Rheumatoid Arthritis following a Treatment with IFN-alpha/Ribavirin against HCV Infection

Yasumori Izumi, Atsumasa Komori, Yuki Yasunaga, Satoru Hashimoto, Taiichiro Miyashita, Seigo Abiru, Hiroshi Yatsuhashi, Hiromi Ishibashi, Kiyoshi Migita

Author information

Yasumori Izumi
Department of Rheumatology, NHO Nagasaki Medical Center, Japan
Department of General Internal Medicine, NHO Nagasaki Medical Center, Japan
Atsumasa Komori
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Yuki Yasunaga
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Satoru Hashimoto
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Taiichiro Miyashita
Department of Rheumatology, NHO Nagasaki Medical Center, Japan
Department of General Internal Medicine, NHO Nagasaki Medical Center, Japan
Seigo Abiru
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Hiroshi Yatsuhashi
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Hiromi Ishibashi
Department of Hepatology, NHO Nagasaki Medical Center, Japan
Kiyoshi Migita
Department of Rheumatology, NHO Nagasaki Medical Center, Japan

Keywords: anti-cyclic citrullinated peptide antibodies, B cell activating factor belonging to the TNF-family (BAFF), hepatitis C virus, interferon, ribavirin, rheumatoid arthritis, shared epitope

JOURNAL OPEN ACCESS

2011 Volume 50 Issue 9 Pages 1065-1068

DOI https://doi.org/10.2169/internalmedicine.50.4790

Details

Abstract

We report a 48-year-old man who developed rheumatoid arthritis (RA) after a successful treatment with peg-IFN-alpha plus ribavirin for chronic hepatitis C virus (HCV) infection. He had a history of smoking and a single copy of the HLA-DRB1 shared epitope (SE). In a retrospective analysis, he exhibited the anti-CCP antibodies before the start of IFN plus ribavirin treatment. However, the titers of anti-CCP antibodies and BAFF levels were elevated by the IFN plus ribavirin therapy. These observations suggest that IFN plus ribavirin therapy may work as a "trigger" for RA in genetically and environmentally predisposed individuals by affecting the cytokine network.

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