Hepatitis C Virus Treatment With Pegylated Interferon-Alfa Therapy Leading to Generalized Interstitial Granuloma Annulare and Review of the Literature

Ahmad, Usman; Li, Xin; Sodeman, Thomas; Daboul, Isam

doi:10.1097/mjt.0b013e318209e049

Cited by 16 publications

(11 citation statements)

References 10 publications

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“…Granuloma annulare has also been reported to develop at sites of resolved herpes zoster . In addition to these diseases, granuloma annulare induced by drugs such as allopurinol, pegylated IFN‐α, topiramate and TNF‐α inhibitors (infliximab, adalimumab and etanercept) has also been reported previously . Interestingly, it makes sense that IFN‐α, which activates macrophages, induces granulomatous inflammation, while a TNF‐α inhibitor can also induce granuloma annulare; this reaction was recently called a “paradoxical adverse reaction”.…”

Section: Granuloma Annularementioning

confidence: 63%

What is new in the histogenesis of granulomatous skin diseases?

Asai

2017

The Journal of Dermatology

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A granuloma is a form of inflammation, which predominantly consists of macrophages. It typically develops when the immune system attempts to enclose substances that are usually insoluble and cannot be eliminated to prevent the spread of these substances to the other body compartments. According to the source of the substances, granulomatous diseases can be divided into two groups: infectious and non-infectious. The mechanisms of infectious granuloma formation have been widely investigated because of its easy reproducibility in experimental models, both in vivo and in vitro. On the contrary, mechanisms of non-infectious granuloma formation have not been well investigated because of the difficulty to reproduce this formation in experimental models. In this article, we review our recent understanding of the histogenesis and pathogenesis of granuloma formation, confirmed from studies of infectious granulomas, and we present potential hypotheses of the histogenesis and pathogenesis of non-infectious granulomas based on clinical investigations.

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Section: Granuloma Annularementioning

confidence: 63%

What is new in the histogenesis of granulomatous skin diseases?

Asai

2017

The Journal of Dermatology

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“…GA has been also noted to regress following hepatitis C treatment [5]. In contrast, pegylated interferon treatment for chronic hepatitis C was reported in two cases to trigger GA that resolved following end of therapy [9, 10], which suggests an immunogenic mechanism of GA. Hepatitis B vaccination has been associated with new onset GA in two cases [11, 12].…”

Section: Discussionmentioning

confidence: 99%

Chronic Hepatitis with Liver Granulomas in a Patient with Granuloma Annulare: A Case Report and Review of the Literature

Alsahafi

AlJasser

Kalia

et al. 2017

Case Reports in Gastrointestinal Medicine

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Granuloma annulare (GA) is a benign granulomatous skin disorder of unknown etiology. GA is rarely associated with liver diseases. We report a unique case of chronic hepatitis with liver granulomas in a patient with GA. Despite an extensive workup, no clear etiology for the hepatitis was found. Based on the possible immune pathophysiology of GA and the presence of liver granulomas, the patient was treated with prednisone and azathioprine which resulted in complete normalization of the liver enzymes and concurrent improvement of GA. The association between liver diseases and GA is reviewed.

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“…41,[44][45][46][47] Although the cutaneous manifestations and the lag period varied with each drug, the histologic findings were consistent with GA in all cases. Allopurinol-induced generalized interstitial GA presented as multiple, asymptomatic, red, raised lesions that appeared after 6 months of treatment with allopurinol.…”

Section: Clinical Presentationmentioning

confidence: 91%

“…44 Pegylated IFN-a for hepatitis C infection was reported to induce generalized GA in 2 different reports following 6 and 24 weeks of treatment. 45 Generalized GA was also reported following hepatitis B vaccine, 46 amlodipine, 47 and topiramate. 48 Gold was reported to induce papular GA. 39,49 Anti-TNF was reported also to induce GA. 41 A case series study assessed 199 patients with RA and 127 with spondyloarthropathies, treated with anti-TNF antagonists.…”

Section: Clinical Presentationmentioning

confidence: 93%