Skip to main content
PMC home page
Current Therapeutic Research, Clinical and Experimental logoLink to Current Therapeutic Research, Clinical and Experimental
. 2007 Jul;68(4):271–277. doi: 10.1016/j.curtheres.2007.08.006

Loss of Smell (Anosmia) and Taste (Ageusia) in a Patient Treated with Pegylated Interferon Alfa and Ribavirin

Ahmed Yacoob Mayet 1,*
PMCID: PMC3967281  PMID: 24683217

Abstract

Introduction: Anosmia, the loss of the sense of smell, is a rare adverse event associated with interferon alpha (INF-α). Millions of patients with hepatitis B and hepatitis C virus (HCV) infection are currently treated with INF-alfa-2a daily. Only 5 cases of anosmia have been reported in the literature, and none was associated with pegylated INF-alfa.

Case summary: A 55-year-old Arab male (height, 5′1″; weight, 81 kg) with chronic HCV developed anosmia and ageusia (loss of the sense of taste) after 36 weeks of treatment for HCV with subcutaneous pegylated INF-alfa-2a 180 μg and ribavirin 1200 mg. Treatment was continued for 12 additional weeks before being discontinued. Twenty-four weeks after treatment was discontinued, HCV-RNA was undetectable and, during the same visit, the patient reported that he had regained his sense of smell a few weeks previously. The Naranjo algorithm score was 7, representing a probable association of anosmia with INF-alfa-2a treatment. Other etiologies for loss of smell and taste were ruled out.

Conclusions: We report a case of anosmia and ageusia in a patient treated with pegylated INF-alfa-2b and ribavirin for HCV infection. The patient regained his sense of smell and taste within 24 weeks of stopping treatment.

Key words: anosmia, pegylated interferon alfa-2a, ribavirin, hepatitis C virus

Full Text

The Full Text of this article is available as a PDF (407.8 KB).

References

  • 1.Hadziyannis SJ, Sette JH, Morgan TR. Peginterferon-alpha 2a and ribavirin combination therapy in chronic hepatitis C: A randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004;140:346–355. doi: 10.7326/0003-4819-140-5-200403020-00010. [DOI] [PubMed] [Google Scholar]
  • 2.Chen RY, Desmond PV, Locarnini SA. Emerging therapies of hepatitis B and C. J Gastroenterol Hepatol. 2002;17(Suppl):S471–S482. doi: 10.1046/j.1440-1746.17.s4.13.x. [DOI] [PubMed] [Google Scholar]
  • 3.Manzano Alonso ML, Munoz Gomez R, Castellano Tortajada L. Solis Herruzo JA. IFN-induced anosmia and ageusia in chronic hepatitis C [in Spanish]. Gastroenterol Hepatol. 2001;24:412. [PubMed] [Google Scholar]
  • 4.Fernandez Fernandez FJ, Castiella Eguzkiza A, Tejada Calabia AM. Garcia Bengoechea M. Anosmia secondary to treatment with interferon in a patient with chronic hepatitis C [in Spanish]. Gastroenterol Hepatol. 2000;23:499–500. [PubMed] [Google Scholar]
  • 5.Kraus I. Vitezic D. Anosmia induced with alpha interferon in a patient with chronic hepatitis C. Int J Clin Pharmacol Ther. 2000;38:360–361. doi: 10.5414/cpp38360. [DOI] [PubMed] [Google Scholar]
  • 6.Maruyama S, Hirayama C, Kadowaki Y. et al. Interferon-induced anosmia in a patient with chronic hepatitis C. Am J Gastroenterol. 1998;93:122–123. doi: 10.1111/j.1572-0241.1998.122_c.x. [DOI] [PubMed] [Google Scholar]
  • 7.Naranjo CA, Busto U, Sellers EM. et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–245. doi: 10.1038/clpt.1981.154. [DOI] [PubMed] [Google Scholar]
  • 8.Selden AM. New York, NY: Thieme. 1997. Taste and Smell Disorders. [Google Scholar]
  • 9.Physicians' Desk Reference Drug Guide for Mental Health Professionals. 56th ed. Thomson Medical Economics, Inc; Montvale, NJ: 2002. [Google Scholar]
  • 10.Kharoubi S. Drug induced anosmia with nifedipine. Presse Med. 2003;32:1269–1272. [in French] [PubMed] [Google Scholar]
  • 11.Doty RL, Philip S, Reddy K. Kerr KL. Influences of antihypertensive and antihyperlipidemic drugs on the senses of taste and smell: A review. J Hypertens. 2003;21:1805–1813. doi: 10.1097/00004872-200310000-00003. [DOI] [PubMed] [Google Scholar]
  • 12.Ackerman BH. Kasbekar N. Disturbances of taste and smell induced by drugs. Pharmacotherapy. 1997;17:482–496. [PubMed] [Google Scholar]
  • 13.Yakirevitch A, Talmi YP, Baram Y. et al. Effects of cisplatin on olfactory function in cancer patients. BrJ Cancer. 2005;92:1611–1613. doi: 10.1038/sj.bjc.6602544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Epstein JB, Phillips N, Parry J. Quality of life, taste, olfactory and oral function following high-dose chemotherapy and allogeneic hematopoietic cell transplantation. Bone Marrow Transplant. 2002;30:785–792. doi: 10.1038/sj.bmt.1703716. [DOI] [PubMed] [Google Scholar]
  • 15.Schiffman SS, Graham BG, Suggs MS. Sattely-Miller EA. Effect of psychotropic drugs on taste responses in young and elderly persons. Ann NY Acad Sci. 1998;855:732–737. doi: 10.1111/j.1749-6632.1998.tb10652.x. [DOI] [PubMed] [Google Scholar]
  • 16.Young TM. Mathias CJ. Taste and smell disturbance with the alpha-adrenoceptor agonist midodrine. Ann Pharmacother. 2004;38:1868–1870. doi: 10.1345/aph.1E171. [DOI] [PubMed] [Google Scholar]
  • 17.Welge-Luessen A. Wolfensberger M. Reversible anosmia after amikacin therapy. Arch Otolaryngol Head Neck Surg. 2003;129:1331–1333. doi: 10.1001/archotol.129.12.1331. [DOI] [PubMed] [Google Scholar]
  • 18.Benjamin E. Pickles J. Chlorine-induced anosmia. A case presentation. J Laryngol Otol. 1997;111:1075–1076. doi: 10.1017/s0022215100139386. [DOI] [PubMed] [Google Scholar]
  • 19.Whittet HB, Shinkwin C. Freeland AP. Anosmia due to nasal administration of corticosteroid. BMJ. 1991;303:651. doi: 10.1136/bmj.303.6803.651-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Bagheri H, Fouladi A, Barange K. et al. Follow-up of adverse drug reactions from peginterferon alfa-2b-ribavirin therapy. Pharmacotherapy. 2004;24:1546–1553. doi: 10.1592/phco.24.16.1546.50947. [DOI] [PubMed] [Google Scholar]
  • 21.Moulignier A, Allo S, Singer B. Sub-cortico-frontal encephalopathy and choreic movements related to recombinant interferon-alpha 2b. Rev Neurol. 2002;158:567–572. [in French] (Paris) [PubMed] [Google Scholar]
  • 22.Sunami M, Nishikawa T, Yorogi A. Shimoda M. Intravenous administration of levodopa ameliorated a refractory akathisia case induced by interferon-alpha. Clin Neuropharmacol. 2000;23:59–61. doi: 10.1097/00002826-200001000-00012. [DOI] [PubMed] [Google Scholar]
  • 23.Nishihori T, Abdo-Matkiwsky M, Fleishman SB. Blum RH. Severe action tremor related to interferon-alpha 2b therapy for malignant melanoma. Am J Clin Oncol. 2005;28:526. doi: 10.1097/01.coc.0000145982.86749.b4. [DOI] [PubMed] [Google Scholar]
  • 24.Visovsky CG. Peripheral nerve function and symptom distress during biotherapy for malignant melanoma. Can Oncol Nurs J. 2005;15:161–174. doi: 10.5737/1181912x153161167. [DOI] [PubMed] [Google Scholar]
  • 25.Lapinski TW, Nowacka B. Michalewicz M. The peripheral polyneuropathy in patients with chronic HCV infection treated peginterferon alfa with ribavirin [in Polish]. Pol Merkur Lekarski. 2005;18:431–432. [PubMed] [Google Scholar]
  • 26.Hoare M, Woodall T. Alexander GJ. Bell's palsy associated with IFN-alpha and ribavirin therapy for hepatitis C virus infection. J Interferon Cytokine Res. 2005;25:174–176. doi: 10.1089/jir.2005.25.174. [DOI] [PubMed] [Google Scholar]
  • 27.Wong VK, Cheong-Lee C, Ford JA, Yoshida EM. Acute sensorineural hearing loss associated with peginterferon and ribavirin combination therapy during hepatitis C treatment: Outcome after resumption of therapy. World J Gastroenterol. 2005;11:5392–5393. doi: 10.3748/wjg.v11.i34.5392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Bender CM, Monti EJ, Kerr ME. Potential mechanisms of interferon neurotoxicity. Cancer Pract. 1996;4:35–39. [PubMed] [Google Scholar]

Articles from Current Therapeutic Research, Clinical and Experimental are provided here courtesy of Elsevier

RESOURCES