Progressive renal failure and blindness due to retinal hemorrhage after interferon therapy for hepatitis C virus-associated membranoproliferative glomerulonephritis

We treated a 67-year-old Japanese woman with membranoproliferative glomerul onephritis (MPGN) and chronic active hepatitis associated with hepatitis C virus (HCV) infection. Treatment commenced with a daily dose of 6 MU IFN al pha -2b for 2 weeks, which was changed to three times weekly thereafter. Af ter 2 weeks, HCV RNA in the serum was undetectable and there was a concomit ant reduction in proteinuria. Treatment with IFN alpha -2b was discontinued because of severe headache and fever. Five weeks after the discontinuation of IFN alpha -2b, the patient experienced the sudden onset of visual loss due to retinal hemorrhage. Subsequently, proteinuria and renal function pro gressively deteriorated though HCV RNA was undetectable. This case exemplif ies the need for careful monitoring of renal function and retinal lesions n ot only in patients receiving IFN but also in those following the discontin uation of IFN treatment.