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

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.

Identification of a shared gene signature and biological mechanism between diabetic foot ulcers and cutaneous lupus erythemnatosus by transcriptomic analysis

“…Paradoxically, ribavirin combined with cyclophosphamide or interferon has a high risk of skin and appendage adverse reactions (rash, cutaneous sarcoidosis, etc.) (Kato et al, 2021;Zheng et al, 2022).The efficacy of ribavirin in DFU and CLE remains to be further clarified.…”

Acute Fibrinous Anterior Uveitis in a Patient Treated With Topical Interferon-α2b for Ocular Surface Squamous Neoplasia With Uveitis Susceptibility

“…Sarcoidosis panuveitis has been repeatedly described as a possible adverse reaction to systemic IFN-α. 8–10 Besides this, there is only one reported case of AAU secondary to topical IFN-α2b treatment. 11…”

“…7,8 Sarcoidosis panuveitis has been repeatedly described as a possible adverse reaction to systemic IFN-a. [8][9][10] Besides this, there is only one reported case of AAU secondary to topical IFN-a2b treatment. 11 Our rationale behind this case is based on the causality assessment, which consists on evaluating the likelihood that a particular treatment is the cause of an observed adverse effect, being its principles: temporal relationship, biological plausibility, dechallenge, and rechallenge.…”

“…11 Our rationale behind this case is based on the causality assessment, which consists on evaluating the likelihood that a particular treatment is the cause of an observed adverse effect, being its principles: temporal relationship, biological plausibility, dechallenge, and rechallenge. 12 Our hypothesis fulfills the first 3 criteria, as the onset of uveitis corresponds to topical IFN treatment initiation; IFN therapy has been related to immune-mediated side effects, [7][8][9][10][11] and the cessation of treatment led to resolution of the AAU and absence of relapse. Furthermore, laterality also supports the theory of the AAU being an adverse effect of topical IFN-a2b.…”

Oxidative Stress in the Anterior Ocular Diseases: Diagnostic and Treatment

“…U cipitates has proven to be a more and discriminating different caus [191,192]. Similarly, high-resolution raphy scans can be a valuable tool cially in cases that are not active i Interferon-Ƴ release assays using c helpful tool when tuberculosis-asso been published that establishes a si sis and interferon alpha, which sug ical diagnosis of this disease [197].…”