Sahraian Mohammad Ali, Moghadasi Abdorreza Naser, Owji Mahsa, Maboudi Mehrdad, Kosari Farid, McGee Jeanie C, Minagar Alireza
MS Research Center, Neuroscience Institute, Tehran University of Medical Science, Hassan Abad Sq, Tehran, Iran.
J Med Case Rep. 2013 Dec 13;7:270. doi: 10.1186/1752-1947-7-270.
Several cases of sarcoidosis following treatment with interferon-α have been reported in the literature, but those following interferon-β are very rare. We report the case of a patient with multiple sclerosis who developed pulmonary and cutaneous sarcoidosis following treatment with Betaseron® (interferon-β-1b).
A 33-year-old Caucasian woman with a history of multiple sclerosis, treated with interferon-β-1b for 2.5 years developed erythema nodosum in her lower limbs, a breast abscess, and unilateral adenopathy of her left lung. A skin biopsy confirmed sarcoidosis. After the discontinuation of interferon-β-1b and treatment with indomethacin and prednisolone, she recovered.
Sarcoidosis is considered one of the most common multiple sclerosis imitators with involvement of the central nervous system. However, although rare, sarcoidosis can develop following treatment with interferon-β-1b and should be considered in patients with multiple sclerosis treated with beta-interferons who develop pulmonary or extra-pulmonary manifestations of sarcoidosis. Interferon-β-1b discontinuation is the first and most important step in the treatment of such cases followed by treatment with corticosteroids.
文献中已报道了数例α-干扰素治疗后发生结节病的病例，但β-干扰素治疗后发生结节病的情况非常罕见。我们报告了1例多发性硬化症患者，在使用倍泰龙（干扰素β-1b）治疗后发生了肺部和皮肤结节病。
1例33岁白种女性，有多发性硬化症病史，用干扰素β-1b治疗2.5年后出现下肢结节性红斑、乳腺脓肿和左肺单侧淋巴结病。皮肤活检确诊为结节病。停用干扰素β-1b并使用吲哚美辛和泼尼松龙治疗后，患者康复。
结节病被认为是累及中枢神经系统的最常见的多发性硬化症模仿疾病之一。然而，尽管罕见，但结节病可在干扰素β-1b治疗后发生，对于接受β-干扰素治疗的多发性硬化症患者出现结节病的肺或肺外表现时应考虑到该病。停用干扰素β-1b是此类病例治疗的首要也是最重要的步骤，随后用皮质类固醇进行治疗。
