Cutaneous sarcoidosis developing after treatment with pegylated interferon and ribavirin: a new case and review of the literature

López, Verónica; Molina, Inmaculada; Monteagudo, Carlos; Jordá, Esperanza

doi:10.1111/j.1365-4632.2010.04728.x

Cited by 29 publications

(9 citation statements)

References 36 publications

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“…Paradoxically, TNF-antagonists, including infliximab and etanercept, induced sarcoidosis or sarcoid-like diseases in autoimmune rheumatologic diseases6,7. The second setting is related with interferon alpha with or without ribavirin in patient with chronic hepatitis C or melanoma8-11. The third setting is antineoplastic agent-associated sarcoidosis in patient with hematologic malignancies, such as lymphoma and leukemia, or solid tumors12,13.…”

Section: Discussionmentioning

confidence: 99%

A Case of Capecitabine-Induced Sarcoidosis

et al. 2012

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Sarcoidosis is an inflammatory disease involving multiple-organs with an unknown cause. The new onset of sarcoidosis associated with therapeutic agents has been observed in 3 clinical settings; tumor necrosis factor antagonists in autoimmune rheumatologic diseases, interferon alpha with or without ribavirin in patients with chronic hepatitis C or melanoma, and antineoplastic agent-associated sarcoidosis in patients with hematologic malignancies. Here, we report a female patient who developed sarcoidosis after capecitabine treatment as an adjuvant chemotherapy for sigmoid colon cancer. To our knowledge, this is the first report of a capecitabine-induced sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

A Case of Capecitabine-Induced Sarcoidosis

et al. 2012

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“…The most common adverse event described is a flu-like syndrome and redness at the injection site 154,155. Cases of cutaneous sarcoidosis have been described after PEG-IFN injection 156. A further concern is toxicity, because interruption of treatment will not lead to rapid drug elimination.…”

Section: Experimental Agentsmentioning

confidence: 99%

Risk-benefit considerations in the treatment of relapsing-remitting multiple sclerosis

Ioia¹,

Travaglini²,

Pietrolongo³

et al. 2013

NDT

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Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system and mainly affects young adults. Its natural history has changed in recent years with the advent of disease-modifying drugs, which have been available since the early 1990s. The increasing number of first-line and second-line treatment options, together with the variable course of the disease and patient lifestyles and expectations, makes the therapeutic decision a real challenge. The aim of this review is to give a comprehensive overview of the main present and some future drugs for relapsing-remitting MS, including risk-benefit considerations, to enable readers to draw their own conclusions regarding the risk-benefit assessment of personalized treatment strategies, taking into account not only treatment-related but also disease-related risks. We performed a Medline literature search to identify studies on the treatment of MS with risk stratification and risk-benefit considerations. We focused our attention on studies of disease-modifying, immunomodulating, and immunosuppressive drugs, including monoclonal antibodies. Here we offer personal considerations, stemming from long-term experience in the treatment of MS and thorough discussions with other neurologists closely involved in the care of patients with the disease. MS specialists need to know not only the specific risks and benefits of single drugs, but also about drug interactions, either in simultaneous or serial combination therapy, and patient comorbidities, preferences, and fears. This has to be put into perspective, considering also the risks of untreated disease in patients with different clinical and radiological characteristics. There is no single best treatment strategy, but therapy has to be tailored to the patient. This is a time-consuming task, rich in complexity, and influenced by the attitude towards risk on the parts of both the patient and the clinical team. The broader the MS drug market becomes, the harder it will be for the clinician to help the patient decide which therapeutic strategy to opt for.

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“…Side‐effects are observed in almost 80% of patients treated with combination therapy over the course of treatment, and the appearance of various skin conditions, such as eczematous and lichenoid eruptions and psoriasis, have been reported . Cutaneous sarcoidosis in varying manifestations has also been reported to develop due to PEG IFN and RBV combination therapy …”

Section: Introductionmentioning

confidence: 99%

Cutaneous sarcoidosis in a chronic hepatitis C patient receiving pegylated interferon and ribavirin therapy

Joshita

Shirahata

Yazaki

et al. 2013

Hepatology Research

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A 61‐year‐old Japanese woman suffered from a small, painful, subcutaneous nodule on the sole of her foot that was 10 mm across in diameter during pegylated interferon (PEG IFN) and ribavirin (RBV) combination therapy for chronic hepatitis C. Skin biopsy revealed multiple non‐caseating granulomas composed of epithelioid histiocytes with multinucleate giant cells, which was consistent with sarcoidosis. Ophthalmologic examination revealed uveitis. Thoracic computed tomography (CT) showed multiple bilateral hilar lymphadenopathies and a diffuse micronodular interstitial pattern of the lungs. Genetic analysis indicated a probable homozygous haplotype of A*02:01‐C*15:02‐B*51:01‐DRB1*16:02‐DQB1*05:02 in human leukocyte antigen regions. The patient was observed carefully without any additional medication because no significant systemic symptoms were noted. Combination therapy was continued for 2 months afterwards. She was asymptomatic for over 3 years of follow up, and repeated hematological and biological investigations and chest CT showed improvement. In conclusion, clinicians should bear sarcoidosis in mind as a complication during PEG IFN and RBV combination therapy. They should also be aware of the usually good prognosis of PEG IFN‐induced cutaneous sarcoidosis in order not to prematurely discontinue a treatment necessary for liver disease; maintenance of PEG IFN treatment may be advised with careful follow up.

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Cutaneous sarcoidosis developing after treatment with pegylated interferon and ribavirin: a new case and review of the literature

Cited by 29 publications

References 36 publications

A Case of Capecitabine-Induced Sarcoidosis

A Case of Capecitabine-Induced Sarcoidosis

Risk-benefit considerations in the treatment of relapsing-remitting multiple sclerosis

Cutaneous sarcoidosis in a chronic hepatitis C patient receiving pegylated interferon and ribavirin therapy

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