Development of sarcoidosis following etanercept treatment: a report of three cases.
After over 10 years of use of tumor necrosis factor-alpha (TNF-α) inhibitors, their side effects and complications are reasonably well documented. Recently, however, granulomatous reactions and cases of complete sarcoidosis have been reported, especially in patients treated with the TNF-α receptor protein, etanercept. This is intriguing because the TNF-α antibody drugs infliximab and adalimumab are reportedly used to treat sarcoidosis. We present three patients who developed sarcoidosis while on etanercept treatment, and discuss if possible differences in cytokine profiles and T regulatory cell function in patients taking different TNF-α inhibitors may explain this paradox.
Skoie
Inger Marie
IM
Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, POB 8100, 4068 Stavanger, Norway. ingermarie_skoie@hotmail.com
Wildhagen
Klaus
K
Omdal
Roald
R
D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012507:Sarcoidosis / Q000139:chemically induced*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; 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