Etanercept ameliorates sarcoidosis arthritis and skin disease.
Sarcoidosis is a systemic disorder of unknown etiology characterized by its pathological hallmark, the noncaseating granuloma. In granulomatous diseases, the proinflammatory peptide mediators, including tumor necrosis factor-alpha (TNF-alpha), are increased in the blood and fluids surrounding the activated macrophages. We describe a patient with chronic sarcoidosis arthropathy and lupus pernio resistant to corticosteroids and disease modifying antirheumatic agents, who responded to the addition of etanercept. We discuss the possible mechanisms of action of anti-TNF agents in granulomatous diseases and suggest that chronic, resistant sarcoidosis requires combination immunosuppressive therapy.
Khanna
Dinesh
D
Division of Rheumatology, Department of Medicine, UCLA Center for the Health Sciences, Los Angeles, California, USA.
Liebling
Michael R
MR
Louie
James S
JS
D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001168:Arthritis / Q000188:drug therapy* / Q000209:etiology; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012507:Sarcoidosis / Q000150:complications / Q000188:drug therapy*; D012871:Skin Diseases / Q000188:drug therapy* / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept