Melatonin is a safe and effective treatment for chronic pulmonary and extrapulmonary sarcoidosis.
Chronic sarcoidosis (CS) is often unresponsive to usual treatments. Melatonin, an immunoregulatory drug, was employed in CS patients in whom usual treatments were ineffective or induced severe side effects. Melatonin was given for 2 yr (20 mg/day in the first year, 10 mg/day in the second year) to 18 CS patients. Pulmonary function tests, chest X rays, pulmonary computed tomography, Ga(67) scintigraphy and angiotensin-converting enzyme (ACE) were assayed at baseline and in the follow-up. Normalization of ACE, improvement of pulmonary parameters and resolution of skin involvement were found in the patients given melatonin. After 24 months of melatonin therapy, hylar adenopathy completely resolved in eight patients and parenchymal lesions were markedly improved in all patients; in the five patients with reduced diffusion capacity of the lung for carbon monoxide, the values normalized after 6 months of therapy and remained stable until month 24. After 24 months, Ga(67) pulmonary and extra-pulmonary uptake was totally normalized in seven patients and, at month 12 months, ACE was normalized in six patients in which the values were high at the baseline. Skin lesions, present in three patients, completely disappeared at month 24 months. No side effects were experienced and no disease relapse was observed during melatonin treatment. Melatonin may be an effective and safe therapy for CS when other treatments fail or cause side effects.
Pignone
Alberto Moggi
AM
Section of Rheumatology, Department of Internal Medicine, University of Florence, Florence, Italy. pignone@unifi.it
Rosso
Angela Del
AD
Fiori
Ginevra
G
Matucci-Cerinic
Marco
M
Becucci
Aureliano
A
Tempestini
Alessio
A
Livi
Riccardo
R
Generini
Sergio
S
Gramigna
Leonardo
L
Benvenuti
Chiara
C
Carossino
Anna Maria
AM
Conforti
Maria Letizia
ML
Perfetto
Federico
F
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008550:Melatonin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood; D010865:Pilot Projects; D012129:Respiratory Function Tests; D012507:Sarcoidosis / Q000188:drug therapy* / Q000473:pathology; D017565:Sarcoidosis, Pulmonary / Q000188:drug therapy* / Q000473:pathology; D012867:Skin / Q000187:drug effects / Q000473:pathology; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D007703:Peptidyl-Dipeptidase A; D008550:Melatonin