Adalimumab induced pulmonary sarcoid reaction

Abstract Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology. There is evidence that Tumor Necrosis Factor alpha (TNF-α) antagonists are useful in the treatment of advanced or refractory disease. However, sarcoidosis-like reaction has been reported with TNF-α blockade...

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Published inRespiratory medicine case reports Vol. 10; pp. 53 - 55
Main Authors Bhargava, S, Perlman, D.M, Allen, T.L, Ritter, J.H, Bhargava, M
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.01.2013
Elsevier
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Summary:Abstract Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology. There is evidence that Tumor Necrosis Factor alpha (TNF-α) antagonists are useful in the treatment of advanced or refractory disease. However, sarcoidosis-like reaction has been reported with TNF-α blockade in other inflammatory conditions. Here we report a case of sarcoid-like reaction in a patient with psoriatic arthritis shortly after initiation of adalimumab therapy. Stopping adalimumab and systemic anti-inflammatory therapy with corticosteroids resulted in resolution of pulmonary symptoms and chest radiographic findings. Though TNF-α plays a critical role in pathogenesis of sarcoidosis, the development of sarcoid reaction with TNF-α blockade is paradoxical and the mechanism of this response remains unknown. TNF-α induced sarcoid-reaction could involve multiple organs. Its development with one agent does not preclude therapy with other TNF-α blockers.
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ISSN:2213-0071
2213-0071
DOI:10.1016/j.rmcr.2013.07.002