Drug-Indiced Aseptic Meningitis: Development of Subacute Sclerosing Panencephalitis Following Repeated Intraventricular Infusion Therapy with Interferon Alpha/Beta

• Published in: Cell biochemistry and biophysics 2011-12, Vol.61 (3), p.699-701
• Main Authors: Imataka, George, Nakagawa, Eiji, Yamanouchi, Hideo, Arisaka, Osamu
• Format: Article
• Language: English
• Subjects: alpha -Interferon; Antibodies; Aseptic meningitis; beta -Interferon; Biochemistry; Biological and Medical Physics; Biomedical and Life Sciences; Biophysics; Biotechnology; Cell Biology; Cerebrospinal fluid; Child; Consciousness; EEG; Female; Glucose; Humans; Infant; Infusions, Intraventricular; Interferon; Interferon-alpha - administration & dosage; Interferon-alpha - adverse effects; Interferon-beta - administration & dosage; Interferon-beta - adverse effects; Life Sciences; Measles; Meningitis, Aseptic - chemically induced; Meningitis, Aseptic - diagnosis; Meningitis, Aseptic - pathology; Meningitis, Aseptic - physiopathology; Neurological complications; Pharmacology/Toxicology; Side effects; Subacute sclerosing panencephalitis; Subacute Sclerosing Panencephalitis - chemically induced; Subacute Sclerosing Panencephalitis - diagnosis; Subacute Sclerosing Panencephalitis - pathology; Subacute Sclerosing Panencephalitis - physiopathology; Time Factors; Translational Biomedical Research
• ISSN: 1085-9195; 1559-0283
• DOI: 10.1007/s12013-011-9228-y

Interferon (IFN)-α was reported to be effective in longterm intrathecal treatment of subacute sclerosing panencephalitis (SSPE). However, the side effects related with longterm use of IFN-α/β are unclear. We evaluated the therapeutic effects of IFN-α/β in a 13-years-old patient with SSPE. The cerebrospinal fluid (CSF) measles antibody titer was 64 × NT/128×HI, IgG-index was 4.5, and the SSPE diagnosis was based on electroencephalography (Jabbour-stage II on admission). With Inosiplex (INP) given orally, IFN-α (3 × 10 6 units) was infused intraventricularly twice-a-week for 1-year. Resultantly, CSF cell count was elevated (2502/3), total protein and glucose levels were normal; however, DIAM occurred repeatedly. Consequently, reduced IFN-α (5 × 10 5 units) with hydrocorton was administered at 2-months interval for 19 months, during which, DIAM occurred four times. Therefore, IFN-β (3 × 10 6 units; twice-a-week) therapy was started and continued for 3 years. Although the symptoms were improved considerably, DIAM recurred after 15-months therapy and CSF cell counts were also elevated (2121/3). Since SSPE progressed to Jabbour-stage IV, indicated by irreversible consciousness disorder, IFN therapy was discontinued and INP monotherapy was followed for another 3 years. We, therefore, concluded that the longterm intraventricular IFN-α/β infusion therapy of SSPE involved the potential risk of DIAM with serious irreversible neurological sequelae and should be monitored carefully.