Sarcoid-like granulomatosis in patients treated with anti-TNFα factors. A case report and review of the literature.
This report describes a 56-year-old woman who developed granulomatous lesions consistent with sarcoidosis during adalimumab therapy for rheumatoid arthritis. Cervical and axillary lymphadenopathy developed approximately 21 months after adalimumab administration. Non-caseating epithelioid cell granulomas consistent with sarcoidosis were detected both in an axillary lymph node specimen and in the bone marrow. Diseases showing similar histologic changes, especially tuberculosis, were excluded, and a diagnosis of sarcoidosis was made. Adalimumab was discontinued, and recovery was observed. The current case is, to our knowledge, the first to describe adalimumab-induced non-caseating granulomas in lymph nodes and bone marrow without pulmonary involvement in a patient treated for rheumatoid arthritis.
2nd Department of Internal Medicine, Medical School of Athens University, "Hippokration" General Hospital of Athens, Athens, Greece. theokanel@gmail.com
Theoni
T
Kanellopoulou
Anna
A
Filiotou
Hariklia
H
Kranidioti
Spyridon P
SP
Dourakis
D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000068879:Adalimumab