Sarcoidosis and hepatitis C: clinical description of 11 cases.
BASIC: To describe the main characteristics and treatment of sarcoidosis in patients with chronic hepatitis C virus (HCV) infection.


METHODS
Retrospective cohort study of patients with chronic HCV infection and sarcoidosis at our tertiary institution.


RESULTS
Eleven cases (eight women, three men) fulfilled the criteria for sarcoidosis. Four cases belong to our population of 3194 (0.12%) HCV patients seen in our department between 2001 and 2008. In five cases, sarcoidosis was triggered by antiviral therapy (consisted of interferon-alpha monotherapy in one case and combined therapy with interferon-alpha and ribavirin in four cases) and developed from 23 to 82 months after completion of therapy in three cases. For these patients, pulmonary adenopathies were found in three patients while two presented cutaneous involvement, one had uveitis and one presented both arthritis and extrapulmonary lymphadenopathies. Two patients received systemic corticosteroids with a favourable outcome. Four treatment-naive patients developed sarcoidosis. Two had pulmonary disease, one had medullar involvement, one had superficial lymphadenopathy and one had arthralgia. Three patients received systemic corticosteroids with chronic outcome in all cases. One of the two patients with an earlier history of sarcoidosis experienced a benign relapse that resolved spontaneously.


CONCLUSIONS
Clinical manifestations of sarcoidosis may occur in HCV patients, especially during or after treatment with immunotherapy. In our experience, sarcoidosis triggered by antiviral therapy was more frequent after completion of therapy, but concording with literature, presented a benign outcome. In sarcoidosis, seen in treatment-naive HCV patients, systemic corticosteroids had to be used more often and outcome was less favourable.
Faurie
Pierre
P
Department of Internal Medicine, Université Claude Bernard Lyon, 1 place de l'Hôpital, Lyon Cedex, France.
Broussolle
Christiane
C
Zoulim
Fabien
F
Trepo
Christian
C
Sève
Pascal
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000139:chemically induced / Q000188:drug therapy; D015331:Cohort Studies; D005260:Female; D016174:Hepacivirus / Q000187:drug effects; D006526:Hepatitis C / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D012507:Sarcoidosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D014605:Uveitis / Q000139:chemically induced / Q000188:drug therapy; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin