An Unexpected Effect of Maraviroc Could Make It a Future Treatment for Sarcoidosis

Goehringer et al discuss the case of a 44-year-old man with HIV who developed pulmonary sarcoidosis and was given maraviroc because of CD4 lymphocytopenia. Intensification of ARV therapy with maraviroc led to both immune restoration and the relief of respiratory symptoms. The diagnosis of sarcoidosis was based on the combination of dyspnea, cough, diffuse micronodular infiltrates (predominantly in the upper right lobe) and bilateral enlarged mediastinal lymph nodes on a computed tomography (CT) scan (Online supplemental file), lymphocytic alveolitis (22% of the total cell count) in bronchoalveolar lavage (BAL) fluid, noncaseating giant-cell granulomas on lymph node biopsy, and negative mycobacterial cultures in BAL and lymph node samples.