Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature.
OBJECTIVE
To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases.


METHODS
Review of the clinical records of the authors' patient and of the literature using the PubMed database.


RESULTS
A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases.


CONCLUSIONS
Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.
Alex
A
Fonollosa
Joseba
J
Artaraz
Iñigo
I
Les
Agustin
A
Martinez-Berriotxoa
Julio Perez
JP
Izquierdo
Alberto Saiz
AS
Lopez
Jesus
J
Gardeazaba
Barbara
B
Berasategui
Nerea
N
Martinez-Alday
D000328:Adult; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D003937:Diagnosis, Differential; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D033401:Microscopy, Acoustic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012507:Sarcoidosis / Q000139:chemically induced* / Q000175:diagnosis; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D015867:Uveitis, Intermediate / Q000139:chemically induced* / Q000175:diagnosis
D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept