title: Manifestation of sarcoidosis during interferon and ribavirin therapy for chronic hepatitis C: a report of two cases.
abstract: Two patients with chronic hepatitis C were treated with alpha 2 beta (alpha2beta) interferon and ribavirin for 6 months. Neither patient responded to therapy. Both patients developed painless skin nodules, the histology of which was compatible with sarcoidosis. During therapy, both patients also had an elevation of angiotensin converting enzyme (ACE) levels. ACE levels reverted to normal and the skin lesions resolved a few months after cessation of interferon/ribavirin therapy. A repeat liver biopsy in one patient at the end of therapy revealed multiple hepatic granulomas (which were not evident on biopsy before therapy). In conclusion, interferon/ribavirin therapy can evoke a sarcoid-like response, with skin lesions, hepatic granuloma, and elevation of ACE levels. These appear to have been reversible in the above cases.
authors.affiliation: Crawford Long Medical Center, An Emory Affiliate, Atlanta, Georgia, USA. nmgitlin@aol.com
authors.forename: Norman
authors.initials: N
authors.lastname: Gitlin
mesh_terms: D001707:Biopsy, Needle; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D012507:Sarcoidosis / Q000139:chemically induced* / Q000473:pathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin