만성 C형간염 환자에서 Peginterferon α-2b와 Ribavirin 병합치료 중 발생한 돌발성 난청 1예
A case of sudden-onset hearing loss in a patient treated with peginterferon α-2b and ribavirin for chronic hepatitis C
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초록
돌발성 난청은 페그인터페론 치료 시에 발생하는 드문 부작용으로 알려져 있다. 저자 등은 60세 만성 C형간염 환자에서 페그인터페론알파와 리바비린 병합치료 중 42주째에 우측 귀에 돌발성 난청이 발생하여, 페그인터페론 치료를 중단하고 스테로이드 투여 후 완전히 회복된 사례를 경험하였다. 페그인터페론 치료 시 청력에 대한 세심한 관찰이 필요하며, 청력소실 발생 시 치료의 지속 여부에 대해서는 발생 시점, 환자의 치료 의지, 청력소실의 정도 등에 따라 임상의가 주의 깊게 판단해야 할 것으로 생각한다.
Abstract
Combination therapy of pegylated interferon α and ribavirin has been associated with various adverse effects, but sudden-onset hearing loss is uncommon. We report a 60-year-old male patient who developed sudden-onset hearing loss during combination therapy with pegylated interferon α and ribavirin for chronic hepatitis C. This patient had been diagnosed with chronic hepatitis C (genotype Ib) and early-stage liver cirrhosis 3 years previously, and had been treated with conventional interferon-α and ribavirin for 12 months. However, 6 months from the end of the treatment course the patient relapsed and received combination retreatment with pegylated interferon α-2b and ribavirin. He developed sudden-onset right-side hearing loss and tinnitus 42 weeks after the start of this retreatment. Pure-tone audiometry revealed a right-side hearing loss of 60～90dB. The patient consequently immediately discontinued the pegylated interferon therapy and was given prednisone 60 mg/day for 10 days, after which the hearing loss had almost completely recovered.
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