[Opportunistic infections and sarcoidosis].
BACKGROUND
In spite of CD4+ T-lymphocytopenia and corticosteroids-induced immune suppression, the risk of opportunistic infection is not usually considered to be increased in sarcoidosis.


METHODS
We describe 5 cases of opportunistic infection in patients with sarcoidosis and CD4+ T- lymphocytopenia. A systematic review of the literature was done.


RESULTS
We describe 2 cases of chronic necroziting aspergillosis, one case of Mycobacterium avium complex pneumonia, one case of pneumocystis pneumonia, and one case of cryptoccocal meningitidis in five patients with sarcoidosis. Four patients were receiving corticosteroids at time of diagnosis. Four patients had CD4+ T-lymphocytopenia. In the literature, we documented 65 cases reports of sarcoidosis complicated by opportunistic infection. At the time of infection diagnosis, 36 patients were receiving corticosteroids. CD4+ T-lymphocytopenia was present in 5 of 11 reported cases. Cryptococcosis was the most common reported infection.


CONCLUSIONS
Opportunistic infectious complications are rare in patients with sarcoidosis. Opportunistic infections mainly occur in patients receiving corticosteroids, and with CD4+ T-lymphocytopenia. Except for cryptococcosis, sarcoidosis by itself does not appear to be a risk factor of opportunistic infection.
Girard
N
N
Service de Pneumologie-Centre des Maladies Orphelines Pulmonaires, Hôpital Louis Pradel, Lyon, France.
Cottin
V
V
Hot
A
A
Etienne-Mastroianni
B
B
Chidiac
C
C
Cordier
J F
JF
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology*; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones