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Correspondence |

Congestive Heart Failure in a Patient With Cutaneous T-Cell Lymphoma Treated With Low-Dose Interferon Alfa-2b

Katherine G. Evans, MD; Alison W. Loren, MD, MS; Alain H. Rook, MD; Ellen J. Kim, MD; Helene L. Glassberg, MD
Arch Dermatol. 2011;147(9):1123-1124. doi:10.1001/archdermatol.2011.246.
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Interferons are natural polypeptides used as biologic therapy in patients with cutaneous T-cell lymphoma (CTCL), melanoma, and hepatitis C. In CTCL, interferon alfa enhances the host's cytotoxic T-cell response through upregulation of CD8+ and natural killer cell activity and downregulation of the helper T cell type 2 cytokine profile.1,2

Interferons are associated with reversible adverse effects including flulike symptoms. From 5% to 15% of patients receiving interferon report cardiovascular adverse effects. Common reactions include hypotension and tachycardia; less frequent adverse effects include arrhythmia, ischemia, cardiomyopathy, atrioventricular block, and congestive heart failure (CHF).3 Herein we describe a patient with CTCL who developed a dose-dependent cardiomyopathy while receiving low-dose interferon alfa-2b.

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Figure 1. The patient presented with multiple erythematous, scaly plaques with follicular prominence on the trunk and extremities.

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Figure 2. Punch biopsy specimens from the abdomen. A, Atypical dermal lymphocytes, follicles with mucin deposition, and lymphocyte exocytosis (hematoxylin-eosin, original magnification ×4). B, CD3+ lymphocytes in the epidermis (CD3, original magnification ×10).

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