Interferon-B-Induced Pulmonary Sarcoidosis in MS
Interferon-B-Induced Pulmonary Sarcoidosis in MS
Introduction: With the increasing use of recombinant α and β interferon therapy for the treatment of various disorders, cases of interferon-associated sarcoidosis have been reported in the literature. The majority of these have been cases of interferon-α-induced sarcoidosis. We present the first case, to the best of our knowledge, of interferon-induced pulmonary sarcoidosis in a patient whose multiple sclerosis was treated with interferon-β.
Case presentation: We present the case of a 30-year-old Caucasian woman who presented with unusually persistent bilateral areas of lung consolidation on serial radiographs. Pulmonary sarcoidosis was diagnosed on transbronchial lung biopsy five months after the initiation of treatment with interferon-β for multiple sclerosis.
Conclusions: Sarcoidosis should be considered in the differential diagnosis of a patient who develops clinical or radiological pulmonary disease while undergoing interferon therapy. It is important to note that interferon-induced sarcoidosis, though usually seen in cases with interferon-α, can occur with interferon-β. Neurologists managing patients with multiple sclerosis should be aware of this association between interferon-β and sarcoidosis and promptly refer patients developing respiratory symptoms for further investigation.
Sarcoidosis is a chronic systemic disease characterized by noncaseating granuloma formation that commonly affects the lungs. In pulmonary sarcoidosis, typical changes on plain chest radiography include hilar lymphadenopathy or reticulonodular infiltrates or both.
The exact etiology of sarcoidosis remains unknown. The existence of an exaggerated immune response to unknown antigenic stimuli has been proposed. A number of immune modulators such as interferon-γ have been implicated. In recent years, with the increasing use of recombinant α and β interferon therapy for the treatment of various disorders, cases of interferon-associated sarcoidosis have been reported in the literature. The majority of these have been cases of interferon-α-induced sarcoidosis. These are described in detail in the Discussion section.
We report the case of a 30-year-old Caucasian woman who presented with unusually persistent bilateral areas of lung consolidation on serial radiographs. Pulmonary sarcoidosis was diagnosed five months after the initiation of treatment with interferon-β for multiple sclerosis. To the best of our knowledge, this represents the first case of interferon-induced pulmonary sarcoidosis in a patient whose multiple sclerosis was treated with interferon-β.
Abstract and Introduction
Abstract
Introduction: With the increasing use of recombinant α and β interferon therapy for the treatment of various disorders, cases of interferon-associated sarcoidosis have been reported in the literature. The majority of these have been cases of interferon-α-induced sarcoidosis. We present the first case, to the best of our knowledge, of interferon-induced pulmonary sarcoidosis in a patient whose multiple sclerosis was treated with interferon-β.
Case presentation: We present the case of a 30-year-old Caucasian woman who presented with unusually persistent bilateral areas of lung consolidation on serial radiographs. Pulmonary sarcoidosis was diagnosed on transbronchial lung biopsy five months after the initiation of treatment with interferon-β for multiple sclerosis.
Conclusions: Sarcoidosis should be considered in the differential diagnosis of a patient who develops clinical or radiological pulmonary disease while undergoing interferon therapy. It is important to note that interferon-induced sarcoidosis, though usually seen in cases with interferon-α, can occur with interferon-β. Neurologists managing patients with multiple sclerosis should be aware of this association between interferon-β and sarcoidosis and promptly refer patients developing respiratory symptoms for further investigation.
Introduction
Sarcoidosis is a chronic systemic disease characterized by noncaseating granuloma formation that commonly affects the lungs. In pulmonary sarcoidosis, typical changes on plain chest radiography include hilar lymphadenopathy or reticulonodular infiltrates or both.
The exact etiology of sarcoidosis remains unknown. The existence of an exaggerated immune response to unknown antigenic stimuli has been proposed. A number of immune modulators such as interferon-γ have been implicated. In recent years, with the increasing use of recombinant α and β interferon therapy for the treatment of various disorders, cases of interferon-associated sarcoidosis have been reported in the literature. The majority of these have been cases of interferon-α-induced sarcoidosis. These are described in detail in the Discussion section.
We report the case of a 30-year-old Caucasian woman who presented with unusually persistent bilateral areas of lung consolidation on serial radiographs. Pulmonary sarcoidosis was diagnosed five months after the initiation of treatment with interferon-β for multiple sclerosis. To the best of our knowledge, this represents the first case of interferon-induced pulmonary sarcoidosis in a patient whose multiple sclerosis was treated with interferon-β.