RAYNAUDS-PHENOMENON AND DIGITAL NECROSIS IN A PATIENT TREATED WITH ALPHA-INTERFERON

In a 43-year old male suffering from idiopathic hypereosinophilic synd rome (HES) since 1984, successfully treated with alfa interferon (alph a IFN) for 32 months, a severe Raynaud's phenomenon of the four extrem ities occured and eventually evolved into digital necrosis within a fe w week. The arterial echography/doppler and plethysmography patterns w ere suggestive of isolated small-to medium-size digital arterie occlus ions. An extensive search for an aetiology of digital necrosis, includ ing complete tests of autoimmunity, remained negative. Two months late r, despite alpha IFN withdrawl and intravenous infusions of ilomedin, the digital ischemia evolved to extensive necrosis that necessitated s everal amputations and a definitive spinal chord stimulation. Patholog ic examination of arteries showed no vasculitis but diffuse arterial o cclusions by thrombi.