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Sarcoïdose au cours du traitement de l’hépatite C par interféron alpha et ribavirine : deux casSarcoidosis during the treatment of hepatitis C by interferon-alpha and ribavirin: two cases.
Authors:L. L    que, A. de Boulard, P. Bielefeld, C. Sgro, P. Hillon, T. Gabreau, B. Champigneulle, H. Makki,J. F. Besancenot
Affiliation:1 Service de médecine interne et maladies systémiques, hôpital Général, CHU, 3, rue du Faubourg-Raines, 21033  Dijon cedex, France;2 centre de pharmacovigilance, hôpital Général, CHU, 3, rue du Faubourg-Raines, 21033 Dijon cedex, France;3 service d’hépatogastroentérologie, hôpital du Bocage, CHU, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, 21033 Dijon cedex, France;4 service de médecine I, centre hospitalier, 2, boulevard de Verdun, 89011 Auxerre cedex, France;5 service de médecine II, centre hospitalier, 2, boulevard de Verdun, 89011 Auxerre cedex, France;6 service de médecine 1, centre hospitalier, rue Claude-Petiet, 21402 Chatillon-sur-Seine, France
Abstract:Introduction. – Interferon-alpha (IFNα) used to treat chronic hepatitis C can be responsible for some side effects. We report two cases of sarcoidosis which appeared in patients treated with IFNα and ribavirin for chronic hepatitis C.Exegesis. – A first patient, treated for 5 months with IFNα and ribavirin because of chronic hepatitis C, after the failure of a first treatment with IFNα alone, was hospitalized for dyspnea. The chest X-ray and scanner revealed an interstitial syndrome and mediastinal adenopathies. Biopsies of bronchial spurs revealed epithelioid and giganto-cellular granuloma. After discontinuation of antiviral treatment and starting corticosteroid therapy, the evolution was favourable but viremia reappeared. A second patient with IFNα and ribavirin for 4 months because of chronic hepatitis C (after the failure of a first treatment with IFNα alone) was hospitalized for fever, arthralgias, erythema nodosa and modification of previous skin scars. The biopsy of a scar showed an epithelioid and giganto-cellular granuloma. After discontinuation of antiviral therapy and starting corticosteroid treatment, the evolution was favourable.Conclusion. – Some publications mention occurrence of sarcoidosis during IFNα therapy, occasionally associated with ribavirin, disappearing after discontinuation of the treatment, though sometimes corticotherapy is necessary. The roles of IFNα and ribavirin are discussed.
Keywords:Mots-clé  : sarcoï  dose    patite C   interfé  ron   ribavirineMots-clé  : sarcoidosis    patitis C   interferon   ribavirin
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