Development of sarcoidosis during interferon alpha 2b and ribavirin combination therapy for chronic hepatitis C--a case report and review of the literature.
Development of sarcoidosis during interferon alpha 2b and ribavirin combination therapy for chronic hepatitis C--a case report and review of the literature.
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干扰素α2b和利巴韦林联合治疗慢性丙型肝炎期间发生结节病——病例报告和文献综述。
DOI：
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发表时间：
2005
影响因子：
1.5
通讯作者：
O. Ovunç
中科院分区：
文献类型：
--
作者：
C. Bolukbas;F. Bolukbas;T. Kebdir;L. Canayaz;A. R. Dalay;Gy Kilic;O. Ovunç
结节病是一种病因不明的慢性肉芽肿性多系统疾病。虽然干扰素γ与结节病的发病机制有关，但只有少数病例与干扰素α治疗有关。我们报告一例慢性丙型肝炎（CHC）谁开发结节病后，干扰素α和利巴韦林治疗。干扰素α和利巴韦林的联合治疗给予一名50岁的女性CHC谁没有回应以前的治疗干扰素α。在开始联合治疗后11个月，她因干咳、呼吸困难和发热入院。胸部X线及胸部电脑断层显示双侧肺门肿块及肺实质结节状浸润。肺功能检查显示轻度限制。纵隔淋巴结活检显示非干酪化性肉芽肿。她被诊断为肺结节病II期，并停止联合治疗。她的症状消退吸入类固醇治疗后。结节病诊断后6个月，患者无症状，对丙型肝炎达到完全持续应答。在三年的随访中，肺结节病和丙型肝炎都没有复发。我们认为，结节病可能会发展在慢性丙型肝炎患者在干扰素α和/或利巴韦林治疗，诊断测试，这种不良反应应在后续行动中进行。
Sarcoidosis is a chronic granulomatous multisystemic disorder of unknown aetiology. Although interferon gamma has been implicated in the pathogenesis of sarcoidosis, only a few cases of sarcoidosis associated with interferon alpha therapy have been reported. We report a case with chronic hepatitis C (CHC) who developed sarcoidosis after the treatment by interferon alpha and ribavirin. The combination therapy of interferon alpha and ribavirin was given to a 50-year-old female with CHC who had not responded to a previous treatment by interferon alpha. She has been admitted with non-productive cough, dyspnoea and fever 11 months after the initiation of combination therapy. Chest x-ray and thorax computed tomography revealed bilateral hilar masses and nodular infiltrations in the lung parenchyma. Pulmonary function test showed a mild restriction. Biopsy of mediastinal lymphadenopathy revealed noncaseating granuloma. She was diagnosed to have pulmonary sarcoidosis at stage II, and the combination treatment was discontinued. Her symptoms regressed after inhaler steroid treatment. Six months after the diagnosis of sarcoidosis, the patient was asymptomatic and a complete sustained response to hepatitis C was achieved. During the three years of follow-up, both pulmonary sarcoidosis and hepatitis C have not recurred. We suggest that sarcoidosis may develop in chronic hepatitis C patients during interferon alpha and/or ribavirin treatment, and diagnostic tests for this adverse effect should be performed during the follow-ups.