Complications of therapySarcoidosis Appearing During Anti-Tumor Necrosis Factor α Therapy: A New “Class Effect” Paradoxical Phenomenon. Two Case Reports and Literature Review
Section snippets
Methods
In addition to the cases presented, we performed a PubMed search with the following keywords: “infliximab,” “adalimumab,” “etanercept,” and “anti-TNF” coupled by the Boolean operator “OR.” This search was subsequently coupled with the entry-term “sarcoidosis” by the Boolean operator “AND.” No start date was used for the research strategy that was performed up to August 2008. An additional search through the references of the retrieved papers was performed. We evaluated all series, reviews, and
Case Report 1
The patient was a 45-year-old white man with a 10-year history of severe psoriatic arthritis. The past medical history was unremarkable except for an episode of nephrolithiasis at the age of 20 years. His disease was formerly treated with cyclosporin (3 mg/kg) and methotrexate (MTX) 10 mg/weekly, both stopped due to inefficacy and side effects. Because of the persistence of high disease activity, in January 2002 he was started on intravenous infliximab 5 mg/kg every 6 weeks. Concurrent
Discussion
We describe here 2 cases of pulmonary sarcoidosis that occurred during treatment with anti-TNFα agents (infliximab, adalimumab) for refractory chronic arthritis. Anti-TNFα agents are widely used in the management of many chronic inflammatory diseases, such as rheumatoid arthritis, the spondyloarthritides, Crohn's disease, and psoriasis. Recently, various pulmonary complications have been reported in patients receiving these drugs, including interstitial pneumonitis and worsening of preexisting
Acknowledgment
This research was supported by a grant from Fondazione Cassa di Risparmio di Ferrara.
References (60)
- et al.
The enigmatic development of psoriasis and psoriasiform lesions during anti-TNF therapy: a review
Semin Arthritis Rheum
(2008) - et al.
Treatment of sarcoidosis with infliximab
Chest
(2005) - et al.
Lung injury linked to etanercept therapy
Chest
(2002) - et al.
Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy
Mod Pathol
(2005) Pulmonary sarcoidosis
Medicine
(2008)- et al.
Tumor necrosis factor and granuloma biology: explaining the differential infection risk of etanercept and infliximab
Semin Arthritis Rheum
(2005) - et al.
Infliximab but not etanercept induces apoptosis in lamina propria T-lymphocytes from patients with Crohn's disease
Gastroenterology
(2003) - et al.
Infliximab induces apoptosis in monocytes from patients with chronic active Crohn's disease by using a caspase-dependent pathway
Gastroenterology
(2001) - et al.
Tumor necrosis factor antagonists: different kinetics and/or mechanisms of action may explain differences in the risk for developing granulomatous infection
Semin Arthritis Rheum
(2006) - et al.
Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases
Medicine
(2007)