array:23 [
  "pii" => "S1579212906601924"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(06)60192-4"
  "estado" => "S300"
  "fechaPublicacion" => "2004-01-01"
  "aid" => "60192"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2004"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2004;40:45-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2425
    "formatos" => array:3 [
      "EPUB" => 117
      "HTML" => 1680
      "PDF" => 628
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1579212906601936"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60193-6"
    "estado" => "S300"
    "fechaPublicacion" => "2004-01-01"
    "aid" => "60193"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Arch Bronconeumol. 2004;40:50"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1625
      "formatos" => array:3 [
        "EPUB" => 87
        "HTML" => 998
        "PDF" => 540
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letters to the Editor</span>"
      "titulo" => "Study of Delays in Diagnosing Symptomatic Pulmonary Tuberculosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "50"
        ]
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Casal Rom&#225;n"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Casal Rom&#225;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601936?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000001/v1_201305141816/S1579212906601936/v1_201305141816/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1579212906601912"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60191-2"
    "estado" => "S300"
    "fechaPublicacion" => "2004-01-01"
    "aid" => "60191"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2004;40:41-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2882
      "formatos" => array:3 [
        "EPUB" => 91
        "HTML" => 1890
        "PDF" => 901
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>"
      "titulo" => "Polyradiculitis and Wegener&#39;s Granulomatosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "41"
          "paginaFinal" => "44"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Casanova, E&#46; P&#233;rez Amor, R&#46;M&#46; Gir&#243;n, E&#46; Zamora, M&#46;D&#46; V&#233;lez, J&#46; Ancochea"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Casanova"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "P&#233;rez Amor"
            ]
            2 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "R&#46;M&#46;"
              "apellidos" => "Gir&#243;n"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Zamora"
            ]
            4 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "V&#233;lez"
            ]
            5 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Ancochea"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601912?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004000000001/v1_201305141816/S1579212906601912/v1_201305141816/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>"
    "titulo" => "Sarcoidosis Following Combined Ribavirin and Interferon Therapy&#58; a Case Report and Review of the Literature"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "45"
        "paginaFinal" => "49"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "I&#46; Alfageme Michavila, M&#46; Merino S&#225;nchez, J&#46; P&#233;rez Ronchel, I&#46; Lara Lara, E&#46; Su&#225;rez Garc&#237;a, J&#46; L&#243;pez Garrido"
        "autores" => array:6 [
          0 => array:5 [
            "preGrado" => "Dra"
            "nombre" => "I&#46;"
            "apellidos" => "Alfageme Michavila"
            "email" => array:1 [
              0 => "ialfageme&#64;telefonica&#46;net"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Merino S&#225;nchez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "P&#233;rez Ronchel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "I&#46;"
            "apellidos" => "Lara Lara"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Su&#225;rez Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "L&#243;pez Garrido"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Secci&#243;n de Neumolog&#237;a&#44; Hospital Universitario de Valme&#44; Sevilla&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Hospital Universitario de Valme&#44; Sevilla&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Secci&#243;n de Digestivo&#44; Hospital Universitario de Valme&#44; Sevilla&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dra&#46; I&#46; Alfageme&#46; Bobby Deglan&#233;&#44; 5&#44; 3D&#46; 41001 Sevilla&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2003-05-19"
    "fechaAceptado" => "2003-06-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec153098"
          "palabras" => array:5 [
            0 => "Pulmonary sarcoidosis"
            1 => "Hepatitis C"
            2 => "Interferon therapy"
            3 => "Adverse effects interferon therapy"
            4 => "Antiviral agents"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec153099"
          "palabras" => array:5 [
            0 => "Sarcoidosis pulmonar"
            1 => "Hepatitis C"
            2 => "Tratamiento con interfer&#243;n"
            3 => "Efectos adversos del tratamiento con interfer&#243;n"
            4 => "Agentes antivirales"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Treatment of active chronic viral hepatitis type C with interferon alpha has proved effective and therefore its use is being extended to a large number of patients&#46; Common side effects include respiratory manifestations&#46; One side effect attributable to the immunomodulatory effect of interferon is the possible triggering or exacerbation of systemic or cutaneous sarcoidosis&#46; We report a new case and offer an exhaustive review of the literature&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">A 49-year-old man with type C chronic&#44; active hepatitis developed new respiratory symptoms and pulmonary infiltrates with hilar and mediastinal adenopathy after 4 months of treatment with pegylated interferon and ribavirin&#46; The transbronchial biopsy showed multiple sarcoid granulomas&#46; When the patient was diagnosed&#44; he had already taken the total dose of interferon and no specific treatment was started&#46; His hepatitis did not respond to therapy and his viral load and transaminase levels remained high&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El tratamiento con interfer&#243;n alfa en la hepatitis cr&#243;nica activa por el virus C tiene una eficacia demostrada&#44; por ello se est&#225; generalizando su uso a gran n&#250;mero de pacientes&#46; Entre los efectos secundarios&#44; las manifestaciones respiratorias banales son muy frecuentes&#46; Un efecto secundario atribuible al efecto inmunomodulador del interfer&#243;n es la posibilidad de agravar o desencadenar una sarcoidosis cut&#225;nea o sist&#233;mica&#46; Presentamos un nuevo caso y hacemos una exhaustiva revisi&#243;n de la bibliograf&#237;a&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Se comunica el caso de un var&#243;n de 49 a&#241;os con hepatitis cr&#243;nica activa por el virus C que a los 4 meses de tratamiento con interfer&#243;n pegilado m&#225;s ribavirina present&#243; sintomatolog&#237;a respiratoria que no ten&#237;a previamente e infiltrados pulmonares con adenopat&#237;as hiliares y mediast&#237;nicas&#46; En la biopsia transbronquial se apreciaron abundantes granulomas sarcoideos&#46; Cuando se diagnostic&#243;&#44; el paciente hab&#237;a finalizado toda la dosis de interfer&#243;n y no se instaur&#243; ning&#250;n tratamiento espec&#237;fico&#46; La hepatitis no respondi&#243; a la terapia&#44; permaneciendo elevada la carga viral y las transaminasas&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:29 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunology of sarcoidosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "YP Kataria"
                            1 => "JF Holter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "1997"
                        "volumen" => "18"
                        "paginaInicial" => "719"
                        "paginaFinal" => "739"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9413655"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of subcutaneous sarcoid nodules induced by interferon-alpha"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I Ohhata"
                            1 => "T Ochi"
                            2 => "S Kurebayashi"
                            3 => "H Masutani"
                            4 => "M Kikui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nihon yobu Shikkan Gakkai Zasshi"
                        "fecha" => "1994"
                        "volumen" => "32"
                        "paginaInicial" => "996"
                        "paginaFinal" => "1000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrence of sarcoidosis following interferon alpha therapy for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M Nakajima"
                            1 => "Y Kubota"
                            2 => "N Miyashita"
                            3 => "Y Niki"
                            4 => "T Matsushima"
                            5 => "T Manabe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Med"
                        "fecha" => "1996"
                        "volumen" => "35"
                        "paginaInicial" => "376"
                        "paginaFinal" => "379"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8797050"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis after interferon therapy for chronic active hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H Teragawa"
                            1 => "T Hondo"
                            2 => "K Takahashi"
                            3 => "H Watanabe"
                            4 => "H Ohe"
                            5 => "N Hattori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Med"
                        "fecha" => "1996"
                        "volumen" => "35"
                        "paginaInicial" => "19"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8652926"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis in interferon-alpha therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "HG Otte"
                            1 => "C Hartig"
                            2 => "R Stadler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hautarzt"
                        "fecha" => "1997"
                        "volumen" => "48"
                        "paginaInicial" => "482"
                        "paginaFinal" => "487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9333628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis associated with interferon-alpha therapy for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "RM Hoffmann"
                            1 => "MC Jung"
                            2 => "R Motz"
                            3 => "C Gossl"
                            4 => "HP Emslander"
                            5 => "R Zachoval"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "1998"
                        "volumen" => "28"
                        "paginaInicial" => "1058"
                        "paginaFinal" => "1063"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9672184"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous sarcoid foreign body granulomas developing in sites of previous skin injury after systemic interferon-alpha treatment for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B Eberlein-K&#246;nig"
                            1 => "R Hein"
                            2 => "D Abeck"
                            3 => "R Engst"
                            4 => "J Ring"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "140"
                        "paginaInicial" => "370"
                        "paginaFinal" => "372"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10233247"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonal sarcoidosis&#58; a rare side effect of interferon-alpha treatment for chronic hepatitis C infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J Pohl"
                            1 => "W Stremmel"
                            2 => "B Kallinowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-2000-10023"
                      "Revista" => array:6 [
                        "tituloSerie" => "Z Gastroenterol"
                        "fecha" => "2000"
                        "volumen" => "38"
                        "paginaInicial" => "951"
                        "paginaFinal" => "955"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11194885"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Probable cutaneous sarcoidosis associated with combined ribavirin and interferon-alpha therapy for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G Savoye"
                            1 => "O Goria"
                            2 => "S Herve"
                            3 => "G Riachi"
                            4 => "I Noblesse"
                            5 => "L Bastien"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gastroenterol Clin Biol"
                        "fecha" => "2000"
                        "volumen" => "24"
                        "paginaInicial" => "679"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10962394"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic sarcoidosis during interferon-alpha therapy for chronic hepatitis C virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P Cacoub"
                            1 => "A Sbai"
                            2 => "C Frances"
                            3 => "C Genesti"
                            4 => "P Hausfater"
                            5 => "JC Piette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterol Clin Biol"
                        "fecha" => "2000"
                        "volumen" => "24"
                        "paginaInicial" => "364"
                        "paginaFinal" => "366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10804348"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis and IFN-&#40;alpha&#41; treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "NJ Vander Els"
                            1 => "H Gedes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2000"
                        "volumen" => "117"
                        "paginaInicial" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10631240"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of cutaneous sarcoidosis in a patient with chronic hepatitis C treated with interferon alpha 2b"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V Neglia"
                            1 => "S Sookoian"
                            2 => "M Herrera"
                            3 => "A Abeldano"
                            4 => "MC Kien"
                            5 => "E Chouela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cutan Med Surg"
                        "fecha" => "2001"
                        "volumen" => "5"
                        "paginaInicial" => "406"
                        "paginaFinal" => "408"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11915769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis during the treatment of hepatitis C by interferon-alpha and ribavirin&#58; 2 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L Leveque"
                            1 => "A De Boulard"
                            2 => "P Bielefeld"
                            3 => "C Sgro"
                            4 => "P Hillon"
                            5 => "T Gabreau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Med Interne"
                        "fecha" => "2001"
                        "volumen" => "22"
                        "paginaInicial" => "1248"
                        "paginaFinal" => "1252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11794896"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis and comorbidity&#58; retrospective study of 32 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F Bonnet"
                            1 => "J Dubuc"
                            2 => "P Morlat"
                            3 => "X Delbrel"
                            4 => "MS Doutre"
                            5 => "S De Witte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Med Intern"
                        "fecha" => "2001"
                        "volumen" => "22"
                        "paginaInicial" => "619"
                        "paginaFinal" => "623"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis after interferon-alpha treatment in hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H Krehmeier"
                            1 => "EH Egberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dtsch Med Wochenschr"
                        "fecha" => "2001"
                        "volumen" => "126"
                        "paginaInicial" => "460"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11360451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis induced by interferon therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "JG Ravenel"
                            1 => "HP McAdams"
                            2 => "JF Plankeel"
                            3 => "KJ Butnor"
                            4 => "TA Sporn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.177.1.1770199"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "2001"
                        "volumen" => "177"
                        "paginaInicial" => "199"
                        "paginaFinal" => "201"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11418426"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis during combined interferon-alfa and ribavirin therapy in 2 patients with chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J Wendling"
                            1 => "V Descamps"
                            2 => "M Grossin"
                            3 => "P Marcellin"
                            4 => "P Le Bozec"
                            5 => "S Belaich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2002"
                        "volumen" => "138"
                        "paginaInicial" => "546"
                        "paginaFinal" => "547"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11939833"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic sarcoidosis presenting as a granulomatous tattoo reaction secondary to interferon-alpha treatment for chronic hepatitis C and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A Nawras"
                            1 => "MM Alsolaiman"
                            2 => "S Mehboob"
                            3 => "C Bartholomew"
                            4 => "B Maliakkal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dig Dis Sci"
                        "fecha" => "2002"
                        "volumen" => "47"
                        "paginaInicial" => "1627"
                        "paginaFinal" => "1631"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12141827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous sarcoidosis during interferon alfa and ribavirin treatment of hepatitis C virus infection&#58; two cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O Cogrel"
                            1 => "MS Doutre"
                            2 => "V Marliere"
                            3 => "M Beylot-Barry"
                            4 => "P Couzigou"
                            5 => "C Beylot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2002"
                        "volumen" => "146"
                        "paginaInicial" => "320"
                        "paginaFinal" => "324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11903249"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Various sarcoid lesions in a patient induced by interferon therapy for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K Noguchi"
                            1 => "M Enjoji"
                            2 => "M Nakamuta"
                            3 => "R Sugimoto"
                            4 => "K Coto"
                            5 => "H Nawata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Gastroenterol"
                        "fecha" => "2002"
                        "volumen" => "35"
                        "paginaInicial" => "282"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12192210"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manifestation of sarcoidosis during interferon and ribavirin therapy for chronic hepatitis C&#58; a report of two cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N Gitlin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Gastroenterol Hepatol"
                        "fecha" => "2002"
                        "volumen" => "14"
                        "paginaInicial" => "883"
                        "paginaFinal" => "885"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12172411"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sarcoidosis in two patients with chronic hepatitis C treated with interferon&#44; ribavirin and amantadine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R P&#233;rez-&#225;lvarez"
                            1 => "R P&#233;rez-L&#243;pez"
                            2 => "JL Lombrana"
                            3 => "M Rodr&#237;guez"
                            4 => "L Rodrigo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Viral Hepat"
                        "fecha" => "2002"
                        "volumen" => "9"
                        "paginaInicial" => "75"
                        "paginaFinal" => "79"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11851906"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reactivation of sarcoidosis during interferon therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "SD Li"
                            1 => "S Yong"
                            2 => "D Srinivas"
                            3 => "T Van"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastroenterol&#46;"
                        "fecha" => "2002"
                        "volumen" => "37"
                        "paginaInicial" => "50"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12109666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogenesis&#44; natural history&#44; treatment&#44; and prevention of hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "TJ Liang"
                            1 => "B Rehermann"
                            2 => "LB Seeff"
                            3 => "JH Hoofnagle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2000"
                        "volumen" => "132"
                        "paginaInicial" => "296"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10681285"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interferon alfa 2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "JG McHutchison"
                            1 => "SC Gordon"
                            2 => "ER Schiff"
                            3 => "ML Shiffman"
                            4 => "WM Lee"
                            5 => "V Rustgi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1998"
                        "volumen" => "339"
                        "paginaInicial" => "1485"
                        "paginaFinal" => "1492"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomised trial of interferon a2b plus ribavirin for 48 weeks or for 24 weeks versus interferon a2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T Poynard"
                            1 => "P Marcellin"
                            2 => "SS Lee"
                            3 => "C Miederau"
                            4 => "GS Minuk"
                            5 => "G Ideo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1998"
                        "volumen" => "352"
                        "paginaInicial" => "1426"
                        "paginaFinal" => "1432"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C&#58; a randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "MP Manus"
                            1 => "JG McHutchison"
                            2 => "SC Gordon"
                            3 => "VK Rustgi"
                            4 => "M Shiffman"
                            5 => "R Reindollar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "358"
                        "paginaInicial" => "958"
                        "paginaFinal" => "965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11583749"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Side effects of therapy of hepatitis C and their management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "MW Fried"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/jhep.2002.36810"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2002"
                        "volumen" => "36"
                        "paginaInicial" => "S237"
                        "paginaFinal" => "SS44"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12407599"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hydrogen peroxide release by alveolar macrophages from sarcoid patients and by alveolar macrophages from normal after exposure to recombinant interferons &#945; A&#44; &#946; and &#947; and 1&#44;25-dihydroxyvitamin D3"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "AOS Fels"
                            1 => "DF Nathan"
                            2 => "ZA Cohn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1172/JCI113083"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Invest"
                        "fecha" => "1987"
                        "volumen" => "80"
                        "paginaInicial" => "381"
                        "paginaFinal" => "386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2440910"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004000000001/v1_201305141816/S1579212906601924/v1_201305141816/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004000000001/v1_201305141816/S1579212906601924/v1_201305141816/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601924?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 40. Issue 1.
Pages 45-49 (January 2004)
Share
Share
Download PDF
More article options
Vol. 40. Issue 1.
Pages 45-49 (January 2004)
Case Reports
Full text access
Sarcoidosis Following Combined Ribavirin and Interferon Therapy: a Case Report and Review of the Literature
Visits
4705
I. Alfageme Michavilaa,
Corresponding author
ialfageme@telefonica.net

Correspondence: Dra. I. Alfageme. Bobby Deglané, 5, 3D. 41001 Sevilla. España
, M. Merino Sáncheza, J. Pérez Ronchela, I. Lara Larab, E. Suárez Garcíac, J. López Garridob
a Sección de Neumología, Hospital Universitario de Valme, Sevilla, Spain
b Servicio de Anatomía Patológica, Hospital Universitario de Valme, Sevilla, Spain
c Sección de Digestivo, Hospital Universitario de Valme, Sevilla, Spain
This item has received
Article information

Treatment of active chronic viral hepatitis type C with interferon alpha has proved effective and therefore its use is being extended to a large number of patients. Common side effects include respiratory manifestations. One side effect attributable to the immunomodulatory effect of interferon is the possible triggering or exacerbation of systemic or cutaneous sarcoidosis. We report a new case and offer an exhaustive review of the literature.

A 49-year-old man with type C chronic, active hepatitis developed new respiratory symptoms and pulmonary infiltrates with hilar and mediastinal adenopathy after 4 months of treatment with pegylated interferon and ribavirin. The transbronchial biopsy showed multiple sarcoid granulomas. When the patient was diagnosed, he had already taken the total dose of interferon and no specific treatment was started. His hepatitis did not respond to therapy and his viral load and transaminase levels remained high.

Key words:
Pulmonary sarcoidosis
Hepatitis C
Interferon therapy
Adverse effects interferon therapy
Antiviral agents

El tratamiento con interferón alfa en la hepatitis crónica activa por el virus C tiene una eficacia demostrada, por ello se está generalizando su uso a gran número de pacientes. Entre los efectos secundarios, las manifestaciones respiratorias banales son muy frecuentes. Un efecto secundario atribuible al efecto inmunomodulador del interferón es la posibilidad de agravar o desencadenar una sarcoidosis cutánea o sistémica. Presentamos un nuevo caso y hacemos una exhaustiva revisión de la bibliografía.

Se comunica el caso de un varón de 49 años con hepatitis crónica activa por el virus C que a los 4 meses de tratamiento con interferón pegilado más ribavirina presentó sintomatología respiratoria que no tenía previamente e infiltrados pulmonares con adenopatías hiliares y mediastínicas. En la biopsia transbronquial se apreciaron abundantes granulomas sarcoideos. Cuando se diagnosticó, el paciente había finalizado toda la dosis de interferón y no se instauró ningún tratamiento específico. La hepatitis no respondió a la terapia, permaneciendo elevada la carga viral y las transaminasas.

Palabras clave:
Sarcoidosis pulmonar
Hepatitis C
Tratamiento con interferón
Efectos adversos del tratamiento con interferón
Agentes antivirales
Full text is only aviable in PDF
REFERENCES
[1]
YP Kataria, JF Holter.
Immunology of sarcoidosis.
Clin Chest Med, 18 (1997), pp. 719-739
[2]
I Ohhata, T Ochi, S Kurebayashi, H Masutani, M Kikui.
A case of subcutaneous sarcoid nodules induced by interferon-alpha.
Nihon yobu Shikkan Gakkai Zasshi, 32 (1994), pp. 996-1000
[3]
M Nakajima, Y Kubota, N Miyashita, Y Niki, T Matsushima, T Manabe.
Recurrence of sarcoidosis following interferon alpha therapy for chronic hepatitis C.
Intern Med, 35 (1996), pp. 376-379
[4]
H Teragawa, T Hondo, K Takahashi, H Watanabe, H Ohe, N Hattori, et al.
Sarcoidosis after interferon therapy for chronic active hepatitis C.
Intern Med, 35 (1996), pp. 19-23
[5]
HG Otte, C Hartig, R Stadler.
Sarcoidosis in interferon-alpha therapy.
Hautarzt, 48 (1997), pp. 482-487
[6]
RM Hoffmann, MC Jung, R Motz, C Gossl, HP Emslander, R Zachoval, et al.
Sarcoidosis associated with interferon-alpha therapy for chronic hepatitis C.
J Hepatol, 28 (1998), pp. 1058-1063
[7]
B Eberlein-König, R Hein, D Abeck, R Engst, J Ring.
Cutaneous sarcoid foreign body granulomas developing in sites of previous skin injury after systemic interferon-alpha treatment for chronic hepatitis C.
Br J Dermatol, 140 (1999), pp. 370-372
[8]
J Pohl, W Stremmel, B Kallinowski.
Pulmonal sarcoidosis: a rare side effect of interferon-alpha treatment for chronic hepatitis C infection.
Z Gastroenterol, 38 (2000), pp. 951-955
[9]
G Savoye, O Goria, S Herve, G Riachi, I Noblesse, L Bastien, et al.
Probable cutaneous sarcoidosis associated with combined ribavirin and interferon-alpha therapy for chronic hepatitis C.
Gastroenterol Clin Biol, 24 (2000), pp. 679
[10]
P Cacoub, A Sbai, C Frances, C Genesti, P Hausfater, JC Piette.
Systemic sarcoidosis during interferon-alpha therapy for chronic hepatitis C virus infection.
Gastroenterol Clin Biol, 24 (2000), pp. 364-366
[11]
NJ Vander Els, H Gedes.
Sarcoidosis and IFN-(alpha) treatment.
Chest, 117 (2000), pp. 294
[12]
V Neglia, S Sookoian, M Herrera, A Abeldano, MC Kien, E Chouela, et al.
Development of cutaneous sarcoidosis in a patient with chronic hepatitis C treated with interferon alpha 2b.
J Cutan Med Surg, 5 (2001), pp. 406-408
[13]
L Leveque, A De Boulard, P Bielefeld, C Sgro, P Hillon, T Gabreau, et al.
Sarcoidosis during the treatment of hepatitis C by interferon-alpha and ribavirin: 2 cases.
Rev Med Interne, 22 (2001), pp. 1248-1252
[14]
F Bonnet, J Dubuc, P Morlat, X Delbrel, MS Doutre, S De Witte, et al.
Sarcoidosis and comorbidity: retrospective study of 32 cases.
Rev Med Intern, 22 (2001), pp. 619-623
[15]
H Krehmeier, EH Egberts.
Sarcoidosis after interferon-alpha treatment in hepatitis C.
Dtsch Med Wochenschr, 126 (2001), pp. 460
[16]
JG Ravenel, HP McAdams, JF Plankeel, KJ Butnor, TA Sporn.
Sarcoidosis induced by interferon therapy.
AJR Am J Roentgenol, 177 (2001), pp. 199-201
[17]
J Wendling, V Descamps, M Grossin, P Marcellin, P Le Bozec, S Belaich, et al.
Sarcoidosis during combined interferon-alfa and ribavirin therapy in 2 patients with chronic hepatitis C.
Arch Dermatol, 138 (2002), pp. 546-547
[18]
A Nawras, MM Alsolaiman, S Mehboob, C Bartholomew, B Maliakkal.
Systemic sarcoidosis presenting as a granulomatous tattoo reaction secondary to interferon-alpha treatment for chronic hepatitis C and review of the literature.
Dig Dis Sci, 47 (2002), pp. 1627-1631
[19]
O Cogrel, MS Doutre, V Marliere, M Beylot-Barry, P Couzigou, C Beylot.
Cutaneous sarcoidosis during interferon alfa and ribavirin treatment of hepatitis C virus infection: two cases.
Br J Dermatol, 146 (2002), pp. 320-324
[20]
K Noguchi, M Enjoji, M Nakamuta, R Sugimoto, K Coto, H Nawata.
Various sarcoid lesions in a patient induced by interferon therapy for chronic hepatitis C.
J Clin Gastroenterol, 35 (2002), pp. 282-284
[21]
N Gitlin.
Manifestation of sarcoidosis during interferon and ribavirin therapy for chronic hepatitis C: a report of two cases.
Eur J Gastroenterol Hepatol, 14 (2002), pp. 883-885
[22]
R Pérez-álvarez, R Pérez-López, JL Lombrana, M Rodríguez, L Rodrigo.
Sarcoidosis in two patients with chronic hepatitis C treated with interferon, ribavirin and amantadine.
J Viral Hepat, 9 (2002), pp. 75-79
[23]
SD Li, S Yong, D Srinivas, T Van.
Reactivation of sarcoidosis during interferon therapy.
J Gastroenterol., 37 (2002), pp. 50-54
[24]
TJ Liang, B Rehermann, LB Seeff, JH Hoofnagle.
Pathogenesis, natural history, treatment, and prevention of hepatitis C.
Ann Intern Med, 132 (2000), pp. 296-305
[25]
JG McHutchison, SC Gordon, ER Schiff, ML Shiffman, WM Lee, V Rustgi, et al.
Interferon alfa 2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C.
N Engl J Med, 339 (1998), pp. 1485-1492
[26]
T Poynard, P Marcellin, SS Lee, C Miederau, GS Minuk, G Ideo, et al.
Randomised trial of interferon a2b plus ribavirin for 48 weeks or for 24 weeks versus interferon a2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus.
Lancet, 352 (1998), pp. 1426-1432
[27]
MP Manus, JG McHutchison, SC Gordon, VK Rustgi, M Shiffman, R Reindollar, et al.
Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomized trial.
Lancet, 358 (2001), pp. 958-965
[28]
MW Fried.
Side effects of therapy of hepatitis C and their management.
Hepatology, 36 (2002), pp. S237-SS44
[29]
AOS Fels, DF Nathan, ZA Cohn.
Hydrogen peroxide release by alveolar macrophages from sarcoid patients and by alveolar macrophages from normal after exposure to recombinant interferons α A, β and γ and 1,25-dihydroxyvitamin D3.
J Clin Invest, 80 (1987), pp. 381-386
Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?