TREATMENT WITH ALPHA-INTERFERON ASSOCIATED WITH THE DEVELOPMENT OF PARANEOPLASTIC PEMPHIGUS

The use of interferon (INF) is usually considered safe, the major side -effect being a nu-like syndrome, However, with its ability to alter i mmune responsiveness, INP has been associated with the induction of au toimmune diseases. We report a patient with Waldenstrom's macroglobuli naemia who developed a generalized blistering eruption after treatment with systemic INF-alpha 2A (INF) for multiple skin cancers. The patie nt's skin showed histological features, immunofluorescence findings, a nd immunoprecipitation diagnostic of paraneoplastic pemphigus. Despite aggressive treatment the patient died, In our patient, the use of INF was temporally related to the development of paraneoplastic pemphigus . Although interferon has been shown to induce other autoimmune diseas es, to our knowledge this is only the second report of a patient treat ed with an interferon who subsequently developed a fatal autoimmune bl istering disorder. Paraneoplastic pemphigus is a recently described au toimmune bullous disorder with a poor prognosis, The mechanism by whic h INF triggered the paraneoplastic pemphigus is not known.