Sarcoidosis associated with interferon-α therapy for chronic hepatitis C
Sarcoidosis associated with interferon-α therapy for chronic hepatitis C
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DOI：
10.1016/s0168-8278(98)80357-7
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发表时间：
1998-06-01
影响因子：
25.7
通讯作者：
Pape, GR
中科院分区：
文献类型：
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作者：
Hoffmann, RM;Jung, MC;Pape, GR
背景/目的：干扰素-α 治疗慢性丙型肝炎的肺部副作用似乎很少见。到目前为止，仅描述了两例与干扰素-α 治疗慢性丙型肝炎相关的结节病病例。方法/病例：我们报告了三名接受重组干扰素-α 2a 治疗慢性丙型肝炎的患者，其中两名与利巴韦林联合治疗。这些患者在开始干扰素治疗后分别在 12、20 和 21 周出现肺结节病，其中一名患者患有洛夫格伦综合征。一名患者因治疗失败而停止干扰素治疗后才出现结节病。三名患者的结节病临床症状提示存在干扰素-α 的副作用。停止干扰素治疗，所有三例患者分别在症状出现后 5、6 和 8 个月观察到自发缓解。结论：迄今为止，与干扰素α治疗慢性丙型肝炎相关的结节病的发生可能被低估了。这可能是因为结节病的症状和干扰素的常见副作用相似，并且结节病可能在干扰素治疗结束后发生。我们假设干扰素-a 作为辅助性 T 细胞 1 (Th1) 免疫反应的有效刺激剂，可能会触发在结节病中发生的区室化 Th1 反应。
Background/Aims: Pulmonary side effects of interferon-alpha therapy of chronic hepatitis C seem to be rare. So far, only two cases of sarcoidosis in association with interferon-alpha treatment of chronic hepatitis C have been described.Methods/Cases: We report on three patients who were treated with recombinant interferon-alpha 2a for chronic hepatitis C, two of them in combination with ribavirin. These patients developed pulmonary sarcoidosis 12, 20 and 21 weeks, respectively, after beginning interferon therapy, one patient with Lofgren's syndrome. In one patient sarcoidosis emerged only after discontinuation of interferon therapy because of treatment failure. Clinical symptoms of sarcoidosis in the three patients were suggestive of side effects of interferon-alpha. Interferon therapy was discontinued and spontaneous remission was observed in all three cases 5, 6, and 8 months, respectively, after the onset of symptoms.Conclusion: The occurrence of sarcoidosis in association with interferon-alpha therapy for chronic hepatitis C may have been underestimated so far. This could be due to the fact that symptoms of sarcoidosis and common side effects of interferon are similar, and sarcoidosis may occur after the end of interferon therapy. We hypothesize that interferon-a as a potent stimulator for T-helper 1 (Th1) immune responses may trigger the compartmentalized Th1 reaction that has been shown to take place in sarcoidosis.