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以葡萄膜炎为首发症状的干扰素诱导的结节病 1 例报告并文献复习。

Interferon-induced sarcoidosis with uveitis as the initial symptom: a case report and review of the literature.

机构信息

Department of Ophthalmology and Visual Science, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.

出版信息

J Med Case Rep. 2021 Nov 27;15(1):568. doi: 10.1186/s13256-021-03181-x.

Abstract

BACKGROUND

In recent years, numerous studies have reported the development or exacerbation of sarcoidosis due to interferon therapy. However, ocular lesions rarely present as initial symptoms. Herein, we describe a rare case of interferon-α-induced sarcoidosis with uveitis as the initial symptom, and present a review of the relevant literature.

CASE PRESENTATION

This case involved a 62-year-old-Japanese woman with a history of a combination treatment of pegylated interferon-α-2a, ribavirin, and simeprevir, after which she developed granulomatous panuveitis. She was subsequently diagnosed with sarcoidosis following histological examination of skin biopsy specimens. In addition to reporting this case, we performed a literature review of 27 cases (24 case reports) of histopathologically diagnosed interferon-α-induced sarcoidosis published between January 2009 and November 2018.

CONCLUSIONS

Among the reviewed cases, 23 (85.1%) cases developed skin lesions and 19 (70.1%) had lung lesions. Only three cases (11.1%) had accompanying eye lesions. Interferon-α therapy was discontinued in 16 cases (52.9%), and the majority exhibited improvement after systemic corticosteroid treatment. There are few reported cases of interferon-α-induced sarcoidosis with uveitis as the initial symptom. However, if uveitis develops during or after interferon-α treatment, it might represent an initial symptom of interferon-α-induced sarcoidosis, as observed in the present case.

摘要

背景

近年来,大量研究报告称干扰素治疗可引发或加重肉样瘤病。然而,眼部病变很少作为首发症状出现。本文报告一例以葡萄膜炎为首发症状的干扰素-α诱导肉样瘤病,同时进行相关文献复习。

病例介绍

本例为一名 62 岁日本女性,曾接受聚乙二醇干扰素-α-2a、利巴韦林和西米普韦联合治疗,后出现肉芽肿性全葡萄膜炎。皮肤活检组织学检查后,诊断为肉样瘤病。除了报告这例病例,我们还对 2009 年 1 月至 2018 年 11 月间发表的 27 例(24 例病例报告)经组织病理学诊断为干扰素-α诱导肉样瘤病的病例进行了文献复习。

结论

在回顾的病例中,23 例(85.1%)有皮肤病变,19 例(70.1%)有肺部病变。仅 3 例(11.1%)伴有眼部病变。16 例(52.9%)停用了干扰素-α治疗,大多数患者在全身皮质类固醇治疗后病情改善。以葡萄膜炎为首发症状的干扰素-α诱导肉样瘤病报道较少。然而,如在干扰素-α治疗期间或之后出现葡萄膜炎,可能为干扰素-α诱导肉样瘤病的首发症状,正如本病例所见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1e2/8626977/daddd3c2859e/13256_2021_3181_Fig1_HTML.jpg

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