Interferons are used in the therapy of multiple sclerosis, Kaposi's sarcoma, hepatitis and melanoma. Their short half-life that requires frequent injections can be increased by polyethylene glycol (PEG) modification. A 50-year-old patient was diagnosed as having an acrolentiginous melanoma (Breslow >5 mm, Clark level IV) and inguinal lymph node metastases. After surgical excision and lymphadenectomy, immune therapy with 6.0 microg pegylated interferon alpha(2b)/kg body weight, s.c., was started. Cutaneous ulcerations at the injection sites developed 9 months after treatment initiation. The patient also developed blurred vision and presented with binasal scotomas and pathological visually evoked potentials and electroretinogram. The cutaneous ulcerations slowly healed under local therapy and reduction of the concentration of the PEG-modified interferon from 0.86 to 0.43 mg/ml. The dosage was maintained. Two months later, the therapy was stopped due to disease progression. Vision subsequently recovered. Cutaneous reactions evolved at the sites of subcutaneous injections of PEG-modified interferon alpha(2b). Changes in vision can probably be attributed to immunotherapy.

译文

干扰素用于治疗多发性硬化症,卡波西氏肉瘤,肝炎和黑色素瘤。需要频繁注射的短半衰期可以通过聚乙二醇 (PEG) 改性来增加。一名50岁的患者被诊断为患有A性黑色素瘤 (Breslow> 5毫米,Clark IV级) 和腹股沟淋巴结转移。在手术切除和淋巴结切除术后,开始使用6.0 microg聚乙二醇化干扰素 α (2b)/kg体重,s.C.进行免疫治疗。治疗开始后9个月,注射部位出现皮肤溃疡。患者还出现了视力模糊,并出现了双耳暗点和病理性视觉诱发电位和视网膜电图。在局部治疗和PEG修饰的干扰素浓度从0.86降低到0.43 mg/ml的情况下,皮肤溃疡缓慢愈合。维持剂量。两个月后,由于疾病进展,治疗停止。视力随后恢复。皮肤反应在皮下注射PEG修饰的干扰素 α (2b) 的部位发生。视力的变化可能归因于免疫疗法。

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