Sarcoidosis Recurrence Following Lung Transplantation

Müller, Carsten; Briegel, Josef; Haller, M.; Vogelmeier, C. Franz; Bittman, I; Welz, A.; Fürst, H.; Dienemann, Hendrik

doi:10.1097/00007890-199604150-00024

Cited by 52 publications

(21 citation statements)

References 8 publications

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“…Recurrent autoimmune disease has been suggested both after liver transplantation (such as for autoimmune hepatitis and for primary sclerosing cholangitis) and after transplantation of other organs, such as recurrent sarcoidosis in the lung 25 and autoimmune diabetes after pancreas transplantation. 26 Thus, if PBC is an autoimmune disease, it is not surprising that the disease recurs.…”

Section: What Does Recurrence Of Disease Mean For the Pathogenesis Ofmentioning

confidence: 99%

Recurrent primary biliary cirrhosis

Neuberger

2003

Liver Transplantation

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T he rate of primary biliary cirrhosis (PBC) recurrence is uncertain and the different rates described in the literature reflect in part the diagnostic difficulties and in part the use of protocol biopsies, because histologic evidence of PBC recurrence is not always associated with the development of cholestatic liver tests.Recurrence of PBC appears to have little impact on long-term graft function and survival, but, with lengthening follow-up, this may become a greater problem. Whether ursodeoxycholic acid has any effect on the natural history of recurrent PBC has not been assessed.Recurrence of PBC may give some insight to the pathogenesis: The more rapid progression in the allograft compared with in the native liver, the early appearance in the graft of the aberrant distribution of E2 (the main target of the antimitochondrial antigen) and the increased rate of recurrence in those with tacrolimus as the main immunosuppressive agent is compatible with an infective trigger but clearly does not exclude other causes.Although there was some initial controversy, most centers now have reported recurrence of PBC: Recurrence is of importance not only for the patient and the clinician, but also gives potential insight into the etiology of the disease. The etiology of PBC remains uncertain, and the documentation of recurrence and understanding of risk factors may give useful tips concerning the pathophysiology of the condition and so lead to effective treatments.

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Section: What Does Recurrence Of Disease Mean For the Pathogenesis Ofmentioning

confidence: 99%

Recurrent primary biliary cirrhosis

Neuberger

2003

Liver Transplantation

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“…Most interestingly, there are case reports of sarcoidosis patients who suffered from a relapse of sarcoidosis in a transplanted lung despite receiving immunosuppressive therapy [72][73][74]. Conversely, in two out of four cases patients receiving a lung or other organs from a donor who had a spontaneous remission of sarcoidosis in the past were observed to develop sarcoid-like lesions without suffering from sarcoidosis [73].…”

Section: Aetiologymentioning

confidence: 99%

Sarcoidosis: immunopathogenetic concepts and their clinical application

1998

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Our understanding of the immunopathogenesis of sarcoidosis has been advanced by studies of bronchoalveolar lavage cells. Activated macrophages and T-cells have been identified in different compartments of the sarcoid lung and the characteristics of the activation suggest that the cells become activated in the course of a normal immune response. The immune cells communicate via a cytokine network and the measuring of cytokine levels yields subgroups of sarcoidosis patients with different courses of the disease indicating different states of activation of the disease-mediating immune cells. The causative agent of sarcoidosis has not yet been identified; however, some of the described mechanisms can be clinically applied either to detect patients at risk of deterioration or to develop new therapeutic strategies. Using these approaches methotrexate, pentoxifylline and thalidomide have been identified as drugs which effectively suppress sarcoid inflammation and the serum level of soluble interleukin-2 receptors has been delineated to be a serum marker of sarcoid inflammation. Furthermore, analysing the pulmonary cytokine network in sarcoidosis will yield new staging parameters possibly supplying prognostic information and guiding therapeutic intervention.

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“…Sarcoidosis, lymphangioleiomyomatosis, eosinophilic granulomatosis, panbronchiolitis, giant-cell interstitial pneumonia, bronchoalveolar cell carcinoma, emphysema, and desquamative interstitial pneumonia are among the diseases with case reports of recurring disease after lung transplantation. [5][6][7][8][9][10][11] Recurrence of veno-occlusive disease after transplantation has not been reported until now, and lung transplantation was thought to be definitive treatment for pulmonary veno-occlusive disease. With this 1st report of early recurrence after heart-lung transplantation, we believe that extrapulmonary factors may play a role in the pathogenesis of this disease.…”

Section: Discussionmentioning

confidence: 99%