title: Sarcoid-like lung granulomas in a hemodialysis patient treated with a dipeptidyl peptidase-4 inhibitor.
abstract: It has been reported that the inhibition of dipeptidyl peptidase-4 (DPP-4)/CD26 on T-cells by DPP-4 enzymatic inhibitors suppresses lymphocyte proliferation and reduces the production of various cytokines, including tumor necrosis factor (TNF)-α. A 72-year-old female with diabetic nephropathy on hemodialysis developed multiple lung nodules following the administration of vildagliptin. A biopsy demonstrated the histology of granulomas without caseous necrosis. The discontinuation of vildagliptin resulted in the disappearance of the granulomas within 4 months. As granulomatosis often develops in patients under anti-TNF-α therapy, the accumulation of DPP-4 inhibitors or its metabolites is possibly linked to unrecognized complications, such as sarcoid-like lung granulomas.
authors: Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan.
authors: Ken-Ei
authors: KE
authors: Sada
authors: Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan.
authors: Jun
authors: J
authors: Wada
authors: Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan.
authors: Hiroshi
authors: H
authors: Morinaga
authors: Department of Surgery , Kousei Hospital , Okayama , Japan.
authors: Shigeyuki
authors: S
authors: Tuchimochi
authors: Department of Radiology , Okayama University Medical School , Okayama , Japan.
authors: Mayu
authors: M
authors: Uka
authors: Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan.
authors: Hirofumi
authors: H
authors: Makino
keywords: dipeptidyl peptidase-4 inhibitor; granuloma; hemodialysis; vildagliptin