Salih EMRİ, Gül Şerife ÖZ, Apraş Şule BİLGEN

Development of interferon induced sarcoidosis in a patient with familial mediterranean fever

Ailevi akdeniz ateşi tanısıyla kolşisin tedavisinde olan 42 yaşındaki erkek hasta eforla nefes darlığı yakınması ile başvurdu. Hastanın daha önce interferon-alfa (IFN-α) kullanım öyküsü vardı. Göğüs radyografisinde her iki akciğerde diffüz retikülonodüler opasiteler görüldü. Bilgisayarlı toraks tomografisinde mediastinal ve bilateral hiler lenfadenopatiler, translusent dansiteler, konsolidasyonlar, retiküler opasiteler ve subplevral milimetrik kistik alanlar mevcuttu. Pulmoner fonksiyon testlerinde diffüzyon ve vital kapasite bozuklukları saptandı. Histopatolojik değerlendirme granülomatöz lenfadenitle uyumluydu. Hastaya pulmoner sarkoidoz tanısı kondu. Hasta, İFN’ye bağlı sarkoidozun özelliklerine sahip olmakla birlikte, İFN tedavisinin kesilmesiyle semptomların gelişimi arasında kırk iki ay vardır ve bu sure genel olarak beklenenen uzundur. Bu hastada IFN-α kullanım öyküsü, IFN tedavisi ve sarkoidoz gelişimi arasındaki olası birliktelik nedeniyle, sarkoidozdan şüphelenmemizi sağladı.

Ailevi akdeniz ateşi olan bir hastada interferon tedavisine bağlı sarkoidoz gelişimi

A 42-year-old male patient, who had been on colchicine therapy for FMF admitted with dyspnea on exertion. He had a history of interferon-alpha (IFN-α) administration. The chest X-ray showed diffuse distribution of reticulonodular opacities in both lungs. A CT scan of the lungs revealed mediastinal and bilateral hilar lymphadenopathies, translucent densities, consolidations, reticular opacities and subpleural milimetric cystic spaces. Pulmonary-function studies demonstrated defects in diffusing and vital capacity. Histopathological evaluation was compatible with granulomatous lymphadenitis. The patient was diagnosed as having pulmonary sarcoidosis. He reflects the characteristics of IFN-induced sarcoidosis, but the duration between the cessation of IFN therapy and the development of symptoms is fourty-two months, which is longer than usually expected. In this case, history of IFN-α administration led us to suspect sarcoidosis because of a possible association between IFN therapy and the development of sarcoidosis.Key words: Familial Mediterranean Fever, interferon-alpha, Th1 response, granuloma formation, sarcoidosis.

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