Lung sarcoidosis induced by TNF antagonists in rheumatoid arthritis: a case presentation and a literature review.
We report on a 72 year-old woman with long-standing rheumatoid arthritis diagnosed as granulomatosis due to pulmonary sarcoidosis after 49 months of treatment with etanercept. A clinical and radiological improvement was seen after tumor necrosis factor (TNF) antagonist withdrawal plus a course of steroids. Currently, 27 cases of histological proven sarcoidosis with pulmonary involvement have been reported in relation to anti-TNF therapy, with etanercept being more frequent in comparison with the anti-TNF monoclonal antibodies infliximab and adalimumab. Potential pathogenic mechanisms of the paradoxical effect of anti-TNF treatment is discussed. It is important for clinicians to be aware of this potential and uncommon complication of biological therapy with TNF antagonists.
Gifre
Laia
L
Servicio de Reumatología, Hospital Clínic de Barcelona, Barcelona, Spain. lgifre@clinic.ub.es
Ruiz-Esquide
Virginia
V
Xaubet
Antoni
A
Gómez-Puerta
José A
JA
Hernández
M Victoria
MV
Sanmartí
Raimon
R
D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001706:Biopsy; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor; D017565:Sarcoidosis, Pulmonary / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D011241:Prednisone