PROSPECTIVE SONOGRAPHIC EVALUATION OF INTERLEUKIN-2-INDUCED CHANGES IN THE GALLBLADDER

PURPOSE: To describe the changes in the gallbladder induced by interle ukin-2 (IL-2) therapy and to correlate the findings with the clinical course. MATERIALS AND METHODS: Twenty-five men with human immunodefici ency virus (HIV) infection were examined prospectively with right uppe r quadrant ultrasonography (US) before and after receiving IL-2 therap y. Four patients also underwent US after a second course of IL-2. The gallbladder was evaluated for wall thickening, echotexture, and intram ural and pericholecystic fluid. Correlation was made between the clini cal signs and symptoms, IL-2 dose, CD4 cell count, and the US appearan ce of the gallbladder. RESULTS: There was significant correlation betw een symptoms of right upper quadrant pain during IL-2 therapy and US a bnormalities of the gallbladder, including an increase in wall thicken ing (P = .012) and the development of intramural (P = .015) and perich olecystic (P = .006) fluid. More severe abnormalities were seen with h igher IL-2 doses. All symptoms resolved with cessation of IL-2 therapy . In patients who underwent repeat US, the gallbladder reverted to a n ormal appearance. No correlation was found between the CD4 cell count and the development of symptoms or the US appearance of the gallbladde r. CONCLUSION: IL-2-induced changes resolve rapidly with cessation of therapy, and no surgical intervention is needed. These changes can be avoided or reduced by decreasing the IL-2 dose during subsequent cycle s.