Interferon-beta 1A-induced polyarthritis in a patient with the HLA-DRB1*0404 allele

Human interferon-alpha (IFN alpha) and IFN beta are administered for treatm ent of several diseases, including viral infections, malignancies, and mult iple sclerosis (MS), IFN alpha therapy has been associated with the product ion of autoantibodies and the development of a variety of autoimmune disord ers, including polyarthritis. This report describes the development of sero negative, symmetric polyarthritis in a patient with relapsing-remitting MS, after 8 weeks of therapy with IFN beta 1a. HLA phenotyping analysis of the patient revealed the presence of HLA-DRB1*0404, an allele known to be asso ciated with the development of rheumatoid arthritis. Therefore, IFN beta 1a may have induced arthritis in a patient who was genetically predisposed to develop arthritis on the basis of HLA determinants. The English-language l iterature regarding IFN alpha- and IFN beta-induced polyarthritis is review ed, and possible mechanisms for IFN alpha- and IFN beta-induced autoimmunit y, including the contribution of HLA determinants and nitric oxide overprod uction, are discussed.