Thrombotic Microangiopathy Associated with Interferon Beta

"...First, all the patients presented after years of well-tolerated treatment with interferon beta, making an association difficult to recognize. Second, fulminant presentation was associated with severe hypertension. Third, despite the emergency presentation, retrospective review identified chronic changes in all renal-biopsy specimens and a prodrome in three of the four patients with features that included newly diagnosed hypertension, hematologic abnormalities, and renal impairment in the months before diagnosis. We subsequently identified a similar prodrome in a recent fatal case in the United Kingdom. Thrombotic microangiopathy is therefore a serious and potentially fatal complication that has emerged late in the lifetime of recombinant interferon beta therapy. Early manifestations of this complication may be recognizable with increased vigilance, with the potential to mitigate severity..."
http://www.nejm.org/doi/full/10.1056/NEJMc1316118#.U0OjjqB-iIg.twitter