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Updated: Jul 2, 2025
04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
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Refractory Sarcoidosis
Khalid Mahmood1, Nauman Ismat Butt1, Fahmina Ashfaq2
1Department of Medicine & Allied, Azra Naheed Medical College, Superior University, Lahore, Pakistan.
Journal of Ayub Medical College, Abbottabad :, JAMC
|February 26, 2024
Summary
Refractory pulmonary sarcoidosis requires advanced immunosuppressive therapy. This case highlights rituximab as a potential treatment option for patients unresponsive to multiple conventional and biologic agents.
Area of Science:
- Pulmonology
- Immunology
- Rheumatology
Background:
- Sarcoidosis is a multi-organ granulomatous disease with lung involvement.
- While often responsive to glucocorticoids, 10% of cases are refractory, necessitating immunosuppressive therapy.
Observation:
- A 58-year-old female presented with worsening dyspnea and dry cough.
- HRCT revealed pulmonary nodules and hilar lymphadenopathy; biopsy confirmed non-caseating granuloma.
- The patient exhibited resistance to prednisone, azathioprine, methotrexate, infliximab, and mycophenolate mofetil.
Findings:
- Despite multiple treatment lines, the patient's pulmonary sarcoidosis progressed.
- Rituximab was initiated as a last-resort therapy due to treatment failure.
Implications:
- This case underscores the challenges in managing refractory pulmonary sarcoidosis.
- Rituximab may represent a viable therapeutic option for severe, treatment-resistant sarcoidosis.
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