A case of chronic active hepatitis C presenting severe myocarditis during interferon-β therapy

Abstract

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