Fulminant liver failure during interferon beta treatment of multiple sclerosis

Abstract

Although interferon (IFN) β has many adverse effects, including flulike illness, increased spasticity, and laboratory abnormalities,1 autoimmune events are usually limited to autoantibodies with the thyroid the most common target organ involved.2 Liver abnormalities during IFN β therapy are usually clinically asymptomatic and transient biochemical events.1,2⇓ We report a patient who developed acute fulminant liver failure a few weeks after the initiation of IFN β and required an emergency liver transplant. Fulminant failure as a result of IFN β is not well reported in the MS literature and this is the first patient reported who required a liver transplant as a result of MS therapy. A 59-year-old Caucasian woman was transferred to the Intensive Care Unit (ICU) in hepatic coma and hepatorenal syndrome 7 weeks after starting interferon β-1a (Rebif, Serono-Canada, Oakville, Ontario, Canada). One year previously, she developed diplopia and ataxia. An MRI scan disclosed small deep white matter …