title: Adalimumab-associated pulmonary cryptococcosis.
abstract: This is the first report of adalimumab-associated pulmonary cryptococcosis. A 56-year-old female with rheumatoid arthritis without a history of pulmonary disease was simultaneously administered adalimumab (40 mg/2 wks), methotrexate (4 mg/wk), and isoniazid (200 mg/day). Five months later, chest radiography revealed a small spiculated pulmonary nodule, and the laboratory test results, including levels of tumor markers and plasma β-D-glucan, were within normal ranges. Since the lesion continued to grow, even after discontinuing adalimumab, it was surgically resected. Grocott staining of the tissue sample revealed black-brown fungi, identified as Cryptococcus neoformans in culture. The patient now remains well, without adalimumab therapy.
authors: Department of Thoracic Surgery, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan. taiwata@kanrou.net
authors: Takashi
authors: T
authors: Iwata
authors: Teruaki
authors: T
authors: Nagano
authors: Masuhiro
authors: M
authors: Tomita
authors: Yasuo
authors: Y
authors: Suehiro
authors: Shin-Ichi
authors: S
authors: Nakatsuka
authors: Hayato
authors: H
authors: Kimura
authors: Masayuki
authors: M
authors: Sakaki
mesh_terms: D000068879:Adalimumab; D000890:Anti-Infective Agents / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003453:Cryptococcosis / Q000139:chemically induced* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000068879:Adalimumab; D007538:Isoniazid; D008727:Methotrexate