Successful tumor necrosis factor α blockade treatment in therapy‐resistant sarcoidosis

• Published in: Arthritis and rheumatism Vol. 48; no. 12; pp. 3542 - 3543
• Main Authors: Ulbricht, Kai U., Stoll, Matthias, Bierwirth, Janine, Witte, Torsten, Schmidt, Reinhold E.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.12.2003; Wiley
• Subjects: Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Biological and medical sciences; Diseases of the osteoarticular system; Female; Humans; Infliximab; Medical sciences; Middle Aged; Radiography; Sarcoidosis - diagnostic imaging; Sarcoidosis - drug therapy; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Resistance; Treatment; Sarcoidosis; Systemic disease; Rheumatology; Tumor necrosis factor β; Tumor necrosis factor α
• ISSN: 0004-3591; 1529-0131
• DOI: 10.1002/art.11357

Sarcoidosis is a multisystemic disorder histologically characterized by a noncaseating granulomatous inflammatory process. The etiology remains unclear, but tumor necrosis factor α seems to play a crucial role. Herein we describe a patient with severe sarcoidosis involving the lung and liver. Various treatment regimens with azathioprine, methotrexate, cyclophosphamide, and pentoxifylline failed to control the disease. Therefore, salvage therapy with infliximab was commenced. Arthritis and pulmonary and liver involvement improved. We were then able to taper the corticosteroid treatment to a lower‐dose regimen with no need for additional immunosuppressive treatment. To our knowledge, this is the first reported case of successful treatment of multiorgan sarcoidosis that was previously resistant to conventional therapy.