Interferon-induced sarcoidosis with uveitis as the initial symptom: a case report and review of the literature

Abstract

Background: In recent years, numerous studies have reported the development or exacerbation of sarcoidosis due to interferon therapy. However, ocular lesions rarely present as initial symptoms. Herein, we describe a rare case of interferon-α-induced sarcoidosis with uveitis as the initial symptom, and present a review of the relevant literature.

Case presentation: This case involved a 62-year-old-Japanese woman with a history of a combination treatment of pegylated interferon-α-2a, ribavirin, and simeprevir, after which she developed granulomatous panuveitis. She was subsequently diagnosed with sarcoidosis following histological examination of skin biopsy specimens. In addition to reporting this case, we performed a literature review of 27 cases (24 case reports) of histopathologically diagnosed interferon-α-induced sarcoidosis published between January 2009 and November 2018.

Conclusions: Among the reviewed cases, 23 (85.1%) cases developed skin lesions and 19 (70.1%) had lung lesions. Only three cases (11.1%) had accompanying eye lesions. Interferon-α therapy was discontinued in 16 cases (52.9%), and the majority exhibited improvement after systemic corticosteroid treatment. There are few reported cases of interferon-α-induced sarcoidosis with uveitis as the initial symptom. However, if uveitis develops during or after interferon-α treatment, it might represent an initial symptom of interferon-α-induced sarcoidosis, as observed in the present case.

Keywords: Case report; Interferon; Interferon-induced sarcoidosis; Sarcoidosis; Uveitis.

Fig. 1

Imaging findings of a 62-year-old woman with interferon-induced sarcoidosis and uveitis. a Fundus photograph of the left eye shows vitreous opacity, chorioretinal exudates (arrowheads), and retinal hemorrhage (arrows). b Fluorescein angiography of the left eye shows fluorescein leakage from the retinal vein and hyperfluorescence consistent with the exudates

Fig. 2

Chest computed tomography. Hilar and mediastinal lymph node swelling and numerous nodular lesions are seen in the bilateral middle lung lobes

Fig. 3

Histological examination of the skin biopsy specimen reveals noncaseating granulomas (hematoxylin-eosin × 100).