Recovery after l-DOPA treatment in peginterferon and ribavirin induced parkinsonism

• DOI: 10.1016/j.ejim.2007.10.003
• Publication Date: 2007-12-06T19:36:42Z
• Authors: A. Bersano; A. Aghemo; M.G. Rumi; E. Ballabio; L. Candelise; M. Colombo
• Keywords: Male; 0301 basic medicine; Interferon-alpha; Interferon alpha-2; Middle Aged; Antiviral Agents; Recombinant Proteins; Polyethylene Glycols; 3. Good health; Antiparkinson Agents; Levodopa; Benserazide; 03 medical and health sciences; 0302 clinical medicine; Ribavirin; Humans; Drug Therapy, Combination; Parkinson Disease, Secondary; HCV; Levodopa; Parkinsonism; PegInterferon; Side effects

Hepatitis C virus (HCV) chronically infects approximately 2% of the European population. Antiviral therapy with pegInterferon-alpha (PegIFN) and ribavirin (Rbv) is the standard of care, leading to HCV eradication in roughly 50% of patients. IFN-based therapy has been associated with high rates (20%) of central nervous system side effects, but only a few case reports exist on extrapyramidal side effects.We report a 64-year-old man developing parkinsonism during PegIFN alfa-2a and ribavirin therapy for chronic hepatitis C. No improvement was observed after treatment discontinuation. Therefore, on the basis of previous clinical and experimental reports, levodopa-benserazide treatment was started. After substantial improvement, symptoms relapsed following drug tapering.This is the first case of parkinsonism in a Caucasian patient receiving PegIFN/Rbv therapy. The rapid and significant improvement of symptoms obtained in our patient with levodopa-benserazide, suggests that this therapy could be considered as first line symptomatic treatment.