만성 B형 간염에서 Interferon 투여 중 발생한 재생 불량성 빈혈

저자들은 초기 간경변증을 동반한 중증 만성 활동성 B형 간염 환자에서 재조합 alpha IFN 치료 중, 재생 불량성 빈형이 발생한 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다. 환자는 IFN 투여 중지 1개월 후 시행한 골수 생검상 완전한 회복을 보였으며 현재까지 외래에서 관찰 중이다. Aplastic anemia is characterized by decreased bone marrow function with pancytopenia in peripheral blood, and it may be caused by damage to the hematopoietic regulation, microenvironmental defects, or immume suppression of hematopoiesis. The interferon have been used extensively in the treatment of neoplastic, myeloproliferative and viral disease, and it is reported that bone marrow suppression was developed in patients treated with interferin for anticancer or antiviral therapy. Interferon is potents suppressor of cellular proliferation, including hematopoietic colony formation and activates suppressor lymphocytes. Although it is well known that activated suppressor lymphocytes and lymphocyte producing interferon have a role in the pathogenesis of bone marrow failure, full-blown feautres of bone marrow suppression to the degree of alplastic anemia after interferon therapy has been rarely reported. We experienced a case of alpha interferon-induced aplastic anemia in a 46-year-old man with type B chronic active hepatitis superimposed with early cirrhotic changes. He had shown complete and spontaneous recovery of the bone marrow suppression 1 month after discontinuation of interferon treatment.