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Vol. 40. Issue 1.
Pages 45-49 (January 2004)
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Vol. 40. Issue 1.
Pages 45-49 (January 2004)
Case Reports
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Sarcoidosis Following Combined Ribavirin and Interferon Therapy: a Case Report and Review of the Literature
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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
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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
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Copyright © 2004. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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