Asymptomatic systemic sarcoidosis arising 5 years after IFN-alpha treatment for chronic hepatitis C: a new challenge for clinicians.
Interferon (IFN)-induced sarcoidosis is well documented. Herein, we report the case of a patient with chronic hepatitis C (CHC) who developed IFN-alpha-induced sarcoidosis. The clinical features of this case make it unique among all cases so far described. The patient was, in fact, asymptomatic for sarcoidosis, and the disease, characterized by liver and lung granulomatosis, was discovered by chance during the CHC follow-up. The diagnosis was made 5 years after IFN-alpha discontinuation. A pathogenetic role for IFN-alpha in our patient is supported by a liver biopsy performed before the therapy with IFN-alpha was started, showing no evidence of granulomatous localizations. This case suggests that the incidence of sarcoidosis during IFN-alpha treatment is underestimated. A search for clinical and laboratory findings typical of the disease, as well as a liver biopsy, should always be included in the follow-up of CHC patients undergoing therapy with IFN-alpha.
Tortorella
Cosimo
C
Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Bari, Italy. c.tortorella@intmed.uniba.it
Napoli
Nicola
N
Panella
Elisabetta
E
Antonaci
Alessandra
A
Gentile
Antonia
A
Antonaci
Salvatore
S
D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid; D056486:Chemical and Drug Induced Liver Injury; D016207:Cytokines / Q000378:metabolism; D005434:Flow Cytometry; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000139:chemically induced*; D013997:Time Factors
D016207:Cytokines; D007155:Immunologic Factors; D016898:Interferon-alpha