A CASE OF CHRONIC ACTIVE HEPATITIS-C PRESENTING SEVERE MYOCARDITIS DURING INTERFERON-BETA THERAPY

A 47-year-old woman was diagnosed as having chronic active hepatitis C in February, 1995. She was administered 6 MU of interferon (IFN) beta daily, beginning on March 8. After 6 weeks of the treatment she compl ained of chest pain and she entered a state of shock 1 h after adminis tration of IFN. On the electrocardiogram, negative conversion of the T wave at leads: II, III, AVF and V3-6 was seen. Since myocardial ische mia was suspected, catecholamine and nitroglycerin were administered; the symptoms abated, however the electrocardiogram on the fifth day in dicated junctional rhythm. The patient was diagnosed as having myocard itis based on the findings of strongly positive C-reactive protein and elevated erythrocyte sedimentation rate together with the features se en on electrocardiograms, echocardiograms and myocardial scintigrams. After the IFN-beta treatment was discontinued, the clinical symptoms, electrocardiographic and echocardiographic findings improved. The myoc arditis in this case was interpreted as being due to the treatment of IFN-beta, because the patient presented no evidence of previous heart disease.