Pegylated interferon alpha-2a-associated life-threatening Evans' syndrome in a patient with chronic hepatitis C

Abstract In this report, we describe an unusual and unreported complication with the new licensed form of pegylated interferon α2a (PEG-IFN-α2a). We report the first case of severe autoimmune cytopenias, an Evans' syndrome, in a patient with chronic hepatitis C, 2 months after PEG-IFN-α2a initiation. Haemolytic anaemia and thrombocytopenia developed, complicated by gastric bleeding and brain haemorrhage. Outcome was favourable under immunosuppressive treatment. Treatment with PEG-IFN-α2a requires careful follow-up, as IFNα can induce or exacerbate autoimmune diseases.