Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy.
This report details the pulmonary pathologic findings in four patients with rheumatoid arthritis, who developed new onset of pulmonary signs and symptoms with alveolar infiltrates temporally related to the institution of etanercept therapy. Biopsy findings showed an interstitial and air space lymphohistiocytic infiltrate with non-necrotizing granulomas, in the setting of negative cultures and special stains for microorganisms. The association with etanercept therapy and granulomatous reactions is discussed along with the differential diagnosis.
Yousem
Samuel A
SA
The Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213-2582, USA. yousemsa@upmc.edu
Dacic
Sanja
S
D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D017252:CD3 Complex / Q000032:analysis; D018956:CD5 Antigens / Q000032:analysis; D003371:Cough / Q000139:chemically induced; D019938:Cyclin D1 / Q000032:analysis; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000139:chemically induced; D000068800:Etanercept; D005260:Female; D006099:Granuloma / Q000139:chemically induced / Q000473:pathology; D006644:Histiocytes / Q000737:chemistry / Q000187:drug effects / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D007150:Immunohistochemistry; D051917:Leukosialin; D008171:Lung Diseases / Q000139:chemically induced / Q000473:pathology*; D008214:Lymphocytes / Q000737:chemistry / Q000187:drug effects / Q000473:pathology*; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012795:Sialoglycoproteins / Q000032:analysis; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D018501:Antirheumatic Agents; D017252:CD3 Complex; D018956:CD5 Antigens; D019938:Cyclin D1; D000068800:Etanercept; D007074:Immunoglobulin G; D051917:Leukosialin; D018124:Receptors, Tumor Necrosis Factor; D012795:Sialoglycoproteins; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C465014:SPN protein, human