Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis

• Published in: Jornal brasileiro de pneumologia Vol. 40; no. 1; pp. 77 - 81
• Main Authors: Dias, Olívia Meira, Pereira, Daniel Antunes Silva, Baldi, Bruno Guedes, Costa, André Nathan, Athanazio, Rodrigo Abensur, Kairalla, Ronaldo Adib, Carvalho, Carlos Roberto Ribeiro
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Pneumologia e Tisiologia 01.01.2014
• Subjects: Adalimumab; Antibodies, Monoclonal, Humanized - adverse effects; Anticorpos monoclonais humanizados/efeitos adversos; Antirheumatic Agents - adverse effects; Antirreumaticos; Arthritis, Rheumatoid - drug therapy; Artrite reumatoide; Case Report; Doencas pulmonares intersticiais; Female; Humans; Lung Diseases, Interstitial - chemically induced; Middle Aged; RESPIRATORY SYSTEM; Arthritis, rheumatoid; Antirheumatic agents; Anticorpos monoclonais humanizados/efeitos adversos; Antirreumaticos; Doencas pulmonares intersticiais; Artrite reumatoide; Lung diseases, interstitial; Antibodies, monoclonal, humanized/adverse effects
• ISSN: 1806-3713; 1806-3756; 1806-3756
• DOI: 10.1590/S1806-37132014000100012

The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs). There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.