Sarcoidosis triggered by interferon-Beta treatment of multiple sclerosis: a case report and focused literature review. Review uri icon

Overview

abstract

  • OBJECTIVES: To report a rare case of sarcoidosis induced by chronic interferon-beta (a type I interferon) therapy of multiple sclerosis and to review previously reported cases. METHODS: We describe a patient with a prior diagnosis of multiple sclerosis, who developed noncaseating granulomas in her skin and pulmonary lymph nodes, consistent with sarcoidosis, while being treated with recombinant interferon-beta. A retrospective review of the literature was performed using the PubMed database. RESULTS: In our patient, sarcoidosis developed after 3 years of continuous recombinant interferon-beta therapy, dosed 3 times a week. The patient presented with progressive dyspnea on exertion, diffuse arthralgias, low-grade fevers, with an acute onset of rash. The diagnosis of sarcoidosis was secured by finding typical, well-formed, noncaseating granulomas on skin and endobronchial biopsies, with other possible etiologies for granulomatous conditions excluded beforehand. Following the withdrawal of recombinant interferon-beta and a course of corticosteroids combined with disease-modifying anti-rheumatic drug therapy, the patient's clinical presentation resolved. Excluding ours, only 4 additional cases of sarcoidosis developing after interferon-beta therapy have been reported, with 2 of those cases in the context of underlying multiple sclerosis. CONCLUSIONS: Developing sarcoidosis during treatment of multiple sclerosis with recombinant interferon-beta represents an exceedingly rare and paradoxical adverse event. The occurrence of sarcoidosis with the use of this agent is perhaps due to a dysregulation in the modulatory role played by interferon-beta (and more generally type I interferon) expression in chronic inflammation.

publication date

  • May 8, 2012

Research

keywords

  • Interferon-beta
  • Multiple Sclerosis
  • Sarcoidosis

Identity

Scopus Document Identifier

  • 84866501017

Digital Object Identifier (DOI)

  • 10.1016/j.semarthrit.2012.03.008

PubMed ID

  • 22572392

Additional Document Info

volume

  • 42

issue

  • 2