Adalimumab-induced lupus serositis.
A 61-year-old man presented with a 1-month history of breathlessness, chest pain and lethargy. He had been taking adalimumab for ankylosing spondylitis for 2 years. Pleural and pericardial effusions were both found. A video-assisted thorascopic (VATS) pleural and lung biopsy were performed. The pleural pathology showed eosinophils, acute inflammatory cells and lymphoid aggregates. The patient was positive for antinuclear, antidouble-stranded and antihistone antibodies consistent with drug-induced lupus due to adalimumab. His serositis resolved on withdrawal of the drug. Drug-induced lupus can occur as a consequence of anti-TNF-α agents from induction of autoimmunity in a predisposed host.
Department of Respiratory Medicine, Cork University Hospital and School of Medicine, Cork, Ireland.
Dearbhla
D
Kelly
Department of Respiratory Medicine, Cork University Hospital and School of Medicine, Cork, Ireland.
Oisin
O
O'Connell
Department of Respiratory Medicine, Cork University Hospital and School of Medicine, Cork, Ireland.
Michael
M
Henry
D000068879:Adalimumab / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D006332:Cardiomegaly / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000139:chemically induced*; D010996:Pleural Effusion / Q000139:chemically induced*; D012700:Serositis / Q000139:chemically induced*; D013167:Spondylitis, Ankylosing / Q000188:drug therapy; D028761:Withholding Treatment
D000893:Anti-Inflammatory Agents; D000068879:Adalimumab