Abstract
Anti-TNF-alpha agents have been tried in cases of refractory sarcoidosis, giving favourable results. Thus, the occurrence of a granulomatous disease in a patient receiving such drug seems paradoxical. We describe 2 patients with inflammatory rheumatic disease, the first with ankylosing spondylitis, the second with rheumatoid arthritis, under anti-TNF-alpha treatment (infliximab and etanercept respectively) who developed non-caseating granulomas of the lungs and lymph nodes consistent with the diagnosis of sarcoidosis. Limited and various similar cases have been reported. It is generally considered that these granulomatous diseases are related to the anti-TNF-alpha agent.
MeSH terms
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Adult
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Antibodies, Monoclonal / adverse effects*
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Antibodies, Monoclonal / therapeutic use
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Antirheumatic Agents / adverse effects*
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Antirheumatic Agents / therapeutic use
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Etanercept
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Female
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Granuloma / chemically induced
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Granuloma / pathology
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Humans
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Immunoglobulin G / adverse effects*
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Immunoglobulin G / therapeutic use
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Infliximab
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Lung Diseases / chemically induced
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Lung Diseases / pathology
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Lymphatic Diseases / chemically induced
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Lymphatic Diseases / pathology
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Male
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Middle Aged
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Receptors, Tumor Necrosis Factor / therapeutic use
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Rheumatic Diseases / drug therapy*
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Sarcoidosis / chemically induced*
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Sarcoidosis / diagnosis
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Sarcoidosis / pathology
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Substances
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Antibodies, Monoclonal
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Antirheumatic Agents
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Immunoglobulin G
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Receptors, Tumor Necrosis Factor
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Tumor Necrosis Factor-alpha
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Infliximab
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Etanercept