Multisystemic sarcoidosis associated with a second therapy for chronic hepatitis C.

Area of Science:

• Hepatology
• Immunology
• Rheumatology

Background:

• Hepatitis C virus (HCV) infection is a significant global health concern.
• Current standard treatment involves pegylated interferon and ribavirin, achieving sustained viral response in over 50% of patients.
• Interferon-based therapies are known to potentially induce autoimmune diseases, including sarcoidosis.

Observation:

• A case of a multisystemic sarcoidosis (affecting skin, lungs, liver, salivary and lachrymal glands, peripheral nerves) is presented.
• The patient was an African woman with heterozygote sickle cell trait and glucose-6-phosphate-deshydrogenase (G6PD) deficiency.
• Sarcoidosis developed during a second course of pegylated interferon and ribavirin for chronic hepatitis C.

Findings:

• The multisystemic sarcoidosis was confirmed by biopsies.
• Discontinuation of the antiviral therapy resulted in spontaneous regression of all sarcoidosis symptoms within weeks.
• This case highlights a potential adverse effect of interferon-based therapy in a patient with specific genetic predispositions.

Implications:

• This case underscores the importance of monitoring for autoimmune complications during interferon-based HCV treatment.
• It suggests a possible link between interferon therapy, sarcoidosis development, and underlying genetic factors like sickle cell trait and G6PD deficiency.
• Further research may be warranted to elucidate the mechanisms and prevalence of interferon-induced sarcoidosis in diverse patient populations.