case of rhabdomyolysis associated with peginterferon use in chronic hepatitis C

Rhabdomyolysis is a serious clinical condition resulting from release of toxic intracellular materials into the systemic circulation. Multiple factors have been demonstrated to be responsible for this syndrome. However, currently medications and alcohol are considered to be the primary causative agents. To the best of our knowledge there are few reported cases of rhabdomyolysis following prescription of peginterferon alfa-2b in patients with chronic hepatitis. Here, we have reported the case of a 46-year-old male with hepatitis C virus [HCV] infection who suffered an acute onset of generalized myalgia and weakness, with elevated serum creatine phosphokinase [CPK] and lactate dehydrogenase [LDH] levels six months after administration of peginterferon alfa-2b. Considering the clinical picture and laboratory findings, we diagnosed the patient with rhabdomyolysis. Peginterferon alfa-2b and ribavirin were discontinued and intensive intravenous hydration commenced. Within ten days the patient improved significantly after which he was discharged in an appropriate physical condition.

Antiphospholipid antibody syndrome presenting with pulmonary embolism

Antiphospholipid antibody syndrome [APS] is a recently-diagnosed syndrome presenting with arterial and venous thrombosis, recurrent miscarriages and thrombocytopenia in the presence of antiphospholipid antibodies.A 16- year-old man referred due to right sided chest pain, dyspnea and cyanosis of two fingers presented for 2 months. After a complete workup, diagnosis of pulmonary thromboembolism was confirmed through clinical examination, spiral chest CT-scan and lower limb Doppler sonography.He had positive anticardiolipin antibody, lupus anticoagulant, ANA and anti dsDNA. Based on these findings, diagnosis of APS [probably secondary to SLE] was made. Symptoms were improved by anticoagulant, prednisolone and chloroquine therapy. In a conclusion, pulmonary embolism may be the first presentation of APS, especially in young adults.