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Burnevich ES, Popova EN, Ponomarev AB, Nekrasova TP, Lebedeva MV, Filatova AL, Shchanitcyna EM, Ponomareva LA, Beketov VD, Bondarenko IB, Tanashchuk EL, Nikulkina EN, Moiseev SV. Autoimmune liver disease (primary biliary cholangitis/autoimmune hepatitis-overlap) associated with sarcoidosis (clinical cases and literature review). TERAPEVT ARKH 2019; 91:89-94. [PMID: 31090378 DOI: 10.26442/00403660.2019.01.000036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Clinical features of overlap autoimmune hepatitis/primary biliary cholangitis and morphological-proved sarcoid lesions (lungs, lymph nodes, skin) were performed. Data of long-term clinical observation presented in comparison with the results of laboratory datas, instrumental and morphological studies of liver tissue, lungs, skin. The modern aspects of pathogenesis of association autoimmune and granulomatous diseases arediscussed on the example of clinical cases of combination of cholestatic variants of autoimmune hepatitis and generalized sarcoidosis. Keywords: sarcoidosis, autoimmune hepatitis, primary biliary cholangitis, primary biliary cholangitis-autoimmune hepatitis-overlap, extrahepatic manifestations.
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Affiliation(s)
- E S Burnevich
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.,City Clinical Hospital №24 of the Department of Health of Moscow, Moscow, Russia
| | - E N Popova
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - A B Ponomarev
- Department of pathological anatomy, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - T P Nekrasova
- Department of pathological anatomy, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - M V Lebedeva
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - A L Filatova
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E M Shchanitcyna
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - L A Ponomareva
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - V D Beketov
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - I B Bondarenko
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E L Tanashchuk
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - E N Nikulkina
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - S V Moiseev
- Department of internal, occupational diseases and rheumatology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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2
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Babazadeh A, Ebrahimpour S, Afshar Z, Sadeghi-Haddad-Zavareh M, Oladzad S. Unusual isolated extrapulmonary sarcoidosis: Case report. JOURNAL OF ACUTE DISEASE 2019. [DOI: 10.4103/2221-6189.250377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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3
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Chopra A, Nautiyal A, Kalkanis A, Judson MA. Drug-Induced Sarcoidosis-Like Reactions. Chest 2018; 154:664-677. [PMID: 29698718 DOI: 10.1016/j.chest.2018.03.056] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/28/2018] [Accepted: 03/30/2018] [Indexed: 01/02/2023] Open
Abstract
A drug-induced sarcoidosis-like reaction (DISR) is a systemic granulomatous reaction that is indistinguishable from sarcoidosis and occurs in a temporal relationship with initiation of an offending drug. DISRs typically improve or resolve after withdrawal of the offending drug. Four common categories of drugs that have been associated with the development of a DISR are immune checkpoint inhibitors, highly active antiretroviral therapy, interferons, and tumor necrosis factor-α antagonists. Similar to sarcoidosis, DISRs do not necessarily require treatment because they may cause no significant symptoms, quality of life impairment, or organ dysfunction. When treatment of a DISR is required, standard antisarcoidosis regimens seem to be effective. Because a DISR tends to improve or resolve when the offending drug is discontinued, this is another effective treatment for a DISR. However, the offending drug need not be discontinued if it is useful, and antigranulomatous therapy can be added. In some situations, the development of a DISR may suggest a beneficial effect of the inducing drug. Understanding the mechanisms leading to DISRs may yield important insights into the immunopathogenesis of sarcoidosis.
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Affiliation(s)
- Amit Chopra
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY.
| | - Amit Nautiyal
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY
| | - Alexander Kalkanis
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, 401 Military and VA Hospital, Athens, Greece
| | - Marc A Judson
- Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY
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Flores-Robles B, Sangüesa-Gómez C, Barbadillo Mateos C, Roustán-Gullón L, Kovtun I. Sarcoidosis developing after treatment with interferon alpha in a patient with hepatitis C: An association every physician should know. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2017. [DOI: 10.1016/j.rgmxen.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pereira EG, Guimarães TF, Bottino CB, D'Acri AM, Lima RB, Martins CJ. Sarcoidosis and chronic hepatitis C: treatment with prednisone and colchicine. An Bras Dermatol 2017; 91:231-4. [PMID: 27192527 PMCID: PMC4861575 DOI: 10.1590/abd1806-4841.20164029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 10/16/2014] [Indexed: 01/15/2023] Open
Abstract
Sarcoidosis is a disease which still has uncertain etiology. Possible
environmental causes are cited in the literature, like organic and inorganic
particles and infectious agents. Recent studies have demonstrated the occurrence
of sarcoidosis in patients with chronic C hepatitis; however, this association
remains without statistical or causal evidence. In this report a case of
sarcoidosis associated with chronic hepatitis C will be described, with
subcutaneous lesions, considered rare, and good response to treatment with
colchicine and prednisone. The hepatitis C virus was isolated in sarcoid tissue
and the association between the two diseases will be discussed.
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Affiliation(s)
| | | | | | | | | | - Carlos José Martins
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Karne S, Mainor CB, Baer MR. Development of Hypercalcemia in a Patient Receiving Peginterferon alfa-2a Therapy for Polycythemia Vera. Pharmacotherapy 2016; 36:e54-e57. [DOI: 10.1002/phar.1767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sheetal Karne
- Department of Medicine and Marlene and Stewart Greenebaum Cancer Center; University of Maryland School of Medicine; Baltimore Maryland
| | - Candace B. Mainor
- Department of Medicine and Marlene and Stewart Greenebaum Cancer Center; University of Maryland School of Medicine; Baltimore Maryland
| | - Maria R. Baer
- Department of Medicine and Marlene and Stewart Greenebaum Cancer Center; University of Maryland School of Medicine; Baltimore Maryland
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7
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Flores-Robles BJ, Sangüesa-Gómez CP, Barbadillo Mateos C, Roustán-Gullón LG, Kovtun I. Sarcoidosis developing after treatment with interferon alpha in a patient with hepatitis C: An association every physician should know. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2016; 82:185-186. [PMID: 27161792 DOI: 10.1016/j.rgmx.2016.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/25/2015] [Accepted: 01/28/2016] [Indexed: 10/21/2022]
Affiliation(s)
- B J Flores-Robles
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España.
| | - C P Sangüesa-Gómez
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - C Barbadillo Mateos
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - L G Roustán-Gullón
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | - I Kovtun
- Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
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Viana de Andrade ACD, Brito ÉA, Harris OMO, Viana de Andrade APD, Leite MF, Pithon MM. Development of systemic sarcoidosis and xanthoma planum during multiple sclerosis treatment with interferon-beta 1a: Case Report. Int J Dermatol 2014; 54:e140-5. [DOI: 10.1111/ijd.12676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | - Érica Andrade Brito
- Department of Health; Southwest Bahia State University - UESB; Jequié Bahia Brazil
| | | | | | | | - Matheus Melo Pithon
- Department of Health; Southwest Bahia State University - UESB; Jequié Bahia Brazil
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10
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Trien R, Cooper CJ, Paez D, Colon E, Ajmal S, Salameh H. Interferon-alpha-induced sarcoidosis in a patient being treated for hepatitis C. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:235-8. [PMID: 24900166 PMCID: PMC4043539 DOI: 10.12659/ajcr.890180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 01/01/2014] [Indexed: 12/03/2022]
Abstract
PATIENT Female, 43 FINAL DIAGNOSIS: - SYMPTOMS Diarrhea • generalized weakness • headache • lightheadedness • nausea • rash • short of breath • vomiting MEDICATION - Clinical Procedure: - Specialty: Pulmonology. OBJECTIVE Rare diseae. BACKGROUND IFN-alpha-2b in combination with ribavirin is now the standard of care for the treatment of hepatitis C. Sarcoidosis is a chronic multisystem granulomatous disorder characterized by noncaseating granulomas in the involved organs. The pathologic hallmark of sarcoidosis is the presence of noncaseating granulomas in the interstitium that typically involve the lymphatics. CASE REPORT A 43-year-old woman presented to our care with 2-week history of nausea, vomiting, diarrhea, shortness of breath, migraine headache, maculopapular rash, generalized weakness, and lightheadedness. She had been treated for hepatitis C with telaprevir, ribavirin, and interferon-alpha-2b for 6 months. Chest radiograph showed bilateral diffuse prominence of bronchovascular markings. CT of the chest revealed bilateral diffuse centrilobular nodules with associated intralobular septal thickening, thickening of the central peribronchovascular interstitium, nodularity of the major fissures, and mediastinal lymphadenopathy. These findings were suspicious for atypical pulmonary sarcoidosis, possibly interferon-induced. The pathology of the mediastinal lymph node biopsy revealed noncaseating granulomatous inflammation consistent with the diagnosis of pulmonary sarcoidosis. Pathology of the skin punch biopsy showed giant-cell granulomatous inflammation without necrosis. The patient was started on prednisone 40 mg daily with a steroid tapering course for 8 weeks. CONCLUSIONS The management of IFN-induced sarcoidosis includes the discontinuation of IFN therapy with or without the administration of systemic corticosteroids. With the increasing prevalence of HCV in the United States, it is likely that more IFN-alpha-induced sarcoidosis will be encountered by clinicians.
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11
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Drago F, Javor S, Bruzzone L, Drago F, Parodi A, Picciotto A. Pityriasis rosea in a hepatitis B-positive patient treated with pegylated interferon α2a: report of a case and review of the literature. Dermatology 2013; 228:10-3. [PMID: 24335203 DOI: 10.1159/000356176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 10/06/2013] [Indexed: 11/19/2022] Open
Abstract
Pityriasis rosea (PR) is an acute, self-limiting exanthematous disease caused by the endogenous reactivation of human herpesvirus (HHV)-6 and/or HHV-7 infection in conditions of altered immunity. In addition, many drugs have been incriminated as possible triggers of PR-like eruptions, characterized by clinical, morphological and histopathological features that differ from typical PR. Here, we report a case of PR in a patient with chronic hepatitis B, receiving pegylated interferon α2a (PEG-IFN-α2a). PR, arising after the second administration of the PEG-IFN-α2a, might be considered a clinical expression of the patient's altered immune condition as reported in the immune reconstitution inflammatory syndrome affecting patients with human immunodeficiency virus infection after high-dose antiretroviral therapy.
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Affiliation(s)
- Francesco Drago
- Department of Endocrinological and Metabolic Sciences, Section of Dermatology, University of Genoa, Genoa, Italy
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12
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Pisabarros Blanco C, Álvarez Cuenllas B, Gutiérrez Torices C, Linares Torres P, Vivas Alegre S. [Uncommon adverse effects after interferon therapy in patients with hepatitis C]. GASTROENTEROLOGIA Y HEPATOLOGIA 2013; 36:624-5. [PMID: 24018313 DOI: 10.1016/j.gastrohep.2013.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/18/2013] [Accepted: 06/26/2013] [Indexed: 11/16/2022]
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Stouten K, Werken MVD, Tchetverikov I, Saboerali M, Vermeer HJ, Castel R, Verheijen FM. Extreme elevation of serum angiotensin-converting enzyme (ACE) activity: always consider familial ACE hyperactivity. Ann Clin Biochem 2013; 51:289-93. [DOI: 10.1177/0004563213489812] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Measurement of serum angiotensin-converting enzyme (ACE) activity can be helpful in the diagnosis and disease monitoring of sarcoidosis. Elevated serum ACE activity is found in 60–70% of sarcoidosis patients. Usually, the ACE activity is mildly increased (<3-fold the upper limit of the reference range) in sarcoidosis patients. Extremely elevated ACE activity is suggestive of the benign condition known as ‘familial hyperactivity of ACE’. Familial hyperactivity of ACE is a relatively rare condition and can be confirmed by genetic testing. Considering a genetic cause of strongly elevated serum ACE activity is important to prevent possible overdiagnostics. Here, we highlight the factors that may complicate the interpretation of serum ACE activity measurements, and we present two cases that illustrate the importance of interdisciplinary consultation when extremely elevated serum ACE activity is measured.
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Affiliation(s)
- Karlijn Stouten
- Department of Clinical Chemistry, Albert Schweitzer Hospital, The Netherlands
| | | | - Ilja Tchetverikov
- Department of Rheumatology, Albert Schweitzer Hospital, The Netherlands
| | | | | | - Rob Castel
- Department of Clinical Chemistry, Albert Schweitzer Hospital, The Netherlands
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15
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Buss G, Cattin V, Spring P, Malinverni R, Gilliet M. Two cases of interferon-alpha-induced sarcoidosis Koebnerized along venous drainage lines: new pathogenic insights and review of the literature of interferon-induced sarcoidosis. Dermatology 2013; 226:289-97. [PMID: 23886768 DOI: 10.1159/000346244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. The unique distribution of the skin lesions suggests that tissue damage induced by repeated percutaneous drug injections represents a trigger for the local skin manifestation of sarcoidosis. Interestingly, skin damage was recently found to induce the local expression IFN-α, a well-known trigger of sarcoidosis in predisposed individuals. Here we review the literature on sarcoidosis elicited in the context of IFN-α therapy and propose a new link between the endogenous expression of IFN-α and the induction of disease manifestations in injured skin.
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Affiliation(s)
- G Buss
- Division of Immunology and Allergology, University of Lausanne, Lausanne, Switzerland
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Hopwood M. Perspectives of a self-selected sample of former patients on the long-term health outcomes of interferon-based hepatitis C treatments: an exploratory study. PSYCHOL HEALTH MED 2013; 18:742-50. [PMID: 23458315 DOI: 10.1080/13548506.2013.774429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Research indicates that patients treated with interferon-based regimens can experience persistent neurotoxicity after treatment ceases and new symptoms attributable to the regimens can emerge post-treatment. To explore post-hepatitis C virus (HCV) treatment outcomes, in-depth interviews were conducted with a self-selected sample of people from two Australian states who had completed an interferon-based regimen at least 24-weeks prior to being interviewed. Participants comprised almost equal numbers of men and women aged from 26 to 57 years, who were treated for HCV genotypes 1 through to 4, and included treatment responders, non-responders and those who had relapsed after treatment. Of 27 participants who volunteered to be part of this study, 25 reported persistent physical and psychological side-effects after treatment. Participants perceived a direct causal link between the treatment regimen and their ongoing symptoms. Reportedly, recovery from treatment was inhibited by an absence of a follow-up protocol that identified and addressed patients' post-treatment needs, including medical care for persistent side-effects, referral, and information and advice about lifestyle issues. Although the study's sample was not representative of all people treated for HCV, it is likely that persistent side-effects and their impact can affect other patients following completion of HCV treatments. Further prospective studies of HCV treatment outcomes are needed. In the meantime, the systematic implementation of a follow-up protocol in liver clinics might expedite recovery in patients who experience ongoing adverse health.
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Affiliation(s)
- Max Hopwood
- a National Centre in HIV Social Research , The University of New South Wales , Sydney , Australia
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Kang SM, Baek JY, Hwangbo B, Kim HY, Lee GK, Lee HS. A case of capecitabine-induced sarcoidosis. Tuberc Respir Dis (Seoul) 2012; 72:318-22. [PMID: 23227072 PMCID: PMC3510282 DOI: 10.4046/trd.2012.72.3.318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 01/20/2012] [Accepted: 01/27/2012] [Indexed: 11/27/2022] Open
Abstract
Sarcoidosis is an inflammatory disease involving multiple-organs with an unknown cause. The new onset of sarcoidosis associated with therapeutic agents has been observed in 3 clinical settings; tumor necrosis factor antagonists in autoimmune rheumatologic diseases, interferon alpha with or without ribavirin in patients with chronic hepatitis C or melanoma, and antineoplastic agent-associated sarcoidosis in patients with hematologic malignancies. Here, we report a female patient who developed sarcoidosis after capecitabine treatment as an adjuvant chemotherapy for sigmoid colon cancer. To our knowledge, this is the first report of a capecitabine-induced sarcoidosis.
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Affiliation(s)
- Shin Myung Kang
- Center for Lung Cancer, National Cancer Center, Goyang, Korea. ; Department of Pulmonary and Critical Care Medicine, Gachon University Gil Hospital, Incheon, Korea
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Sionidou M, Spyratos D, Chloros D, Sichletidis L. Interferon α-induced sarcoidosis to a patient with polycythemia vera. BMJ Case Rep 2011; 2011:bcr.01.2011.3740. [PMID: 22696707 DOI: 10.1136/bcr.01.2011.3740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Treatment with interferon (IFN) can precipitate a variety of inflammatory conditions, including sarcoidosis. Although many other systems can be affected, the clinical picture in this case mostly includes cutaneous and pulmonary symptoms. The prognosis is better than the idiopathic form of the disease, and the most effective treatment is considered the discontinuation of antivirus therapy alone or in combination with corticosteroid administration. The authors present the case of a 36-year-old man who developed sarcoidosis stage I after 2 years of IFNα therapy for polycythemia vera.
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Affiliation(s)
- M Sionidou
- Pulmonary Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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