Honsová E, Sticová E, Sperl J
Pracovisti klinické a transplantacní patologie IKEM, Praha.
Cesk Patol. 2007 Jan;43(1):27-30.
Interferon-induced sarcoidosis is well documented. We report a case of sarcoidosis in a patient with hepatitis C virus infection treated with pegylated interferon alpha and ribavirin. The patient developed cutaneous sarcoidosis about 6 months after beginning of the combination therapy. Spontaneous regression of the lesions was noted after discontinuation of the treatment. Interferon-alpha is known to stimulate T helper cells with a TH-1 profile immune response, which is the key immunologic event of a sarcoid granuloma formation. In addition to its antiviral action, ribavirin also enhanced the TH-1 response. Incidence of drug induced sarcoidosis may be underreported, because many symptoms of sarcoidosis mimic the side-effects of interferon as fever, myalgias, arthralgias, fatigue and symptoms of pulmonary diseases.
干扰素诱发的结节病已有充分文献记载。我们报告一例丙型肝炎病毒感染患者在接受聚乙二醇化干扰素α和利巴韦林治疗后发生结节病的病例。该患者在联合治疗开始约6个月后出现皮肤结节病。停药后病变出现自发消退。已知α干扰素可刺激具有TH-1型免疫反应的T辅助细胞，这是结节性肉芽肿形成的关键免疫事件。除了其抗病毒作用外，利巴韦林还增强了TH-1反应。药物性结节病的发病率可能未被充分报道，因为结节病的许多症状类似于干扰素的副作用，如发热、肌痛、关节痛、疲劳和肺部疾病症状。
