title: Exacerbation of interstitial lung disease during etanercept therapy: Two cases.
abstract: We report two cases of interstitial lung disease possibly related to TNF alpha antagonist therapy (etanercept) in patients with rheumatoid arthritis. In both cases, pre-existing interstitial lung disease worsened during etanercept therapy. We found 19 previously published cases of interstitial lung disease in patients who were taking TNF alpha antagonists and had no evidence of infection, raising the possibility of a causal link with the medication. The potential pathophysiological mechanisms remain unknown. Caution is in order when using TNF alpha antagonists in patients with pre-existing lung disease. The development or exacerbation of interstitial lung disease in a patient on TNF alpha antagonist therapy should lead to investigations for a cause. Should these investigations prove negative, the treatment must be discontinued.
authors.affiliation: CHU Clermont-Ferrand, Rheumatology Department, G. Montpied Teaching hospital, 63 000 Clermont-Ferrand, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Tournadre
authors.forename: Julie
authors.initials: J
authors.lastname: Ledoux-Eberst
authors.forename: David
authors.initials: D
authors.lastname: Poujol
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dubost
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Ristori
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept