Sarcoidosis

Question

02/18/2008 04:18PM

Question:

I was diagnosed for Tb after a prolonged low grade fever, weakness and weight loss. I had enlarged liver 2cm and spleen 4 cm.After various tests I was prescribed the following medicines on 8th Oct 2007 1. Rcinex 600 BBF 2. Combutol 1200 OD 3. Pyzina 1500 OD 4. Benadone 20 However, my low grade fever continued to remain at around 100 centigrade even after religiously taking medicines till 14th Dec 2007 (i.e. 2 months one week). I then went to a doctor who is a pulmologist. After doing a biopsy and endoscopy he diagnost for sarcoidosis. The doctor advised me that to take wysolone (omnacortil 40) along with the above mentioned medicines for another month. He also gave me one inhaler SEoflo250 two puffs BD.Dramatically my condition improved from the very third day and since then I have no fever atall and I have regained my lost weight and energy. Now after continuing with 4o mg Wysolone for one month the doctor has tapered down the dose to 05mg and has now stopped. The doctor has advised me to continue Rcinex 6oo for another 2months. I would like to know about my food and meal. Till now I was advised to take highly proteined diet with less fat. However, I am non vegetarian and had till now preferred to avoid Nonveg. I was taking it only once a weak. Can I now take nonveg daily with Rcinex. Does Rcinex any way will harm my liver? Plaease advise.

Answer:

Dear Sir/Madam-

Your doctor was likely concerned about weight loss relating to tuberculosis. If your weight and nutritional status are improving on a vegetarian diet, it is likely to be safe to continue with this diet.

Rifampin (Rcinex) can be toxic to your liver, but now that you are taking fewer drugs for TB the risk of liver damage is less. However, you should avoid drinking alcohol or using other drugs that might damage your liver. If you have any questions about which drugs are safe to use, or how to adjust the dose of other medications while on Rifampin, you should ask your doctor.
Finally, I would assume you have tuberculosis as the primary cause of your disease. Sarcoidosis is a diagnosis of exclusion. That is, we only call it sarcoidosis if no other cause is identified. In your case, you have active TB...so you have TB. It is very important for you to complete the treatment of TB exactly as described by your doctor. If you fail to do so, you may may develop a resistant form of the disease...which may be difficult to cure.
Sincerely,

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Response by:

Elliott D. Crouser, MD
Assistant Professor
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University