title: Recurrent allergic bronchopulmonary aspergillosis in a patient with rheumatoid arthritis treated with etanercept and tocilizumab.
abstract: We report the case of a 68-year-old woman with Stage III and Class II rheumatoid arthritis (RA) that was resistant to prednisolone, methotrexate, and infliximab. After treatment with etanercept or tocilizumab, suspicious allergic bronchopulmonary aspergillosis (ABPA) repeatedly occurred and then rapidly improved after the withdrawal of each drug. We suspect that administration of etanercept and tocilizumab caused suspicious ABPA in this patient. The relevance to the pathogenesis of ABPA under these biological drugs is also discussed.
authors.affiliation: Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Honda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kida
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tomita
authors.forename: Masakazu
authors.initials: M
authors.lastname: Fujii
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ihara
authors.forename: Sho
authors.initials: S
authors.lastname: Goya
authors.forename: Isao
authors.initials: I
authors.lastname: Tachibana
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000139:chemically induced*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; C502936:tocilizumab; D000068800:Etanercept