Sarcoid-like granulomatosis in patients treated with tumor necrosis factor blockers: 10 cases
| Autor: | Daïen, Claire Immediato, Monnier, Agnes, Claudepierre, Pascal, Constantin, Arnaud, Eschard, Jean-Paul, Houvenagel, Eric, Samimi, Mahtab, Pavy, Stephan, Pertuiset, Edouard, Toussirot, Eric, Combe, Bernard, Morel, Jacques, Renseigné, Non |
|---|---|
| Přispěvatelé: | Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Systemic disease MESH: Antirheumatic Agents MESH: Granuloma MESH: Sarcoidosis Pulmonary Gastroenterology Receptors Tumor Necrosis Factor Etanercept MESH: Rheumatic Diseases MESH: Antibodies Monoclonal 0302 clinical medicine Pharmacology (medical) MESH: Aged MESH: Immunoglobulin G Granuloma MESH: Middle Aged Antibodies Monoclonal Middle Aged 3. Good health [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system 030220 oncology & carcinogenesis Antirheumatic Agents Female Sarcoidosis MESH: Immunosuppressive Agents Immunosuppressive Agents medicine.drug Adult MESH: Sarcoidosis medicine.medical_specialty MESH: Skin Diseases Antibodies Monoclonal Humanized Skin Diseases 03 medical and health sciences Rheumatology Sarcoidosis Pulmonary Internal medicine Rheumatic Diseases medicine Adalimumab Humans Aged 030203 arthritis & rheumatology MESH: Humans business.industry MESH: Adult medicine.disease MESH: Receptors Tumor Necrosis Factor Infliximab MESH: Male Discontinuation Surgery Anti-Tumor Necrosis Factor Therapy Immunoglobulin G business MESH: Female |
| Zdroj: | Rheumatology Rheumatology, Oxford University Press (OUP), 2009, 48 (8), pp.883-6. ⟨10.1093/rheumatology/kep046⟩ |
| ISSN: | 1462-0324 1460-2172 |
| DOI: | 10.1093/rheumatology/kep046⟩ |
| Popis: | International audience; OBJECTIVE: TNF blockers have been recently evaluated for treating refractory sarcoidosis and could be efficient. However, several cases of sarcoidosis have been diagnosed during anti-TNF therapy. Here, we report the largest series of sarcoid-like granulomatosis following TNF blocker treatment. METHODS: A call for observations of sarcoid-like granulomatosis following TNF blocker treatment was sent to the members of the French 'Club Rhumatismes et Inflammation'. Histological evidence of granulomatosis was required. RESULTS: Observations of 10 patients [seven females; median age 50.5 (range 27-72) years] with sarcoid-like granulomatosis while on anti-TNF treatment were collected: five were treated with etanercept and five with monoclonal antibodies; four patients received TNF blockers for RA and six for SpA. The median delay between anti-TNF agent introduction and granulomatosis diagnosis was 18 (range 1-51) months. Clinical symptoms were mainly pulmonary and cutaneous. Angiotensin-converting enzyme activity was increased in six cases. Lymph-node and/or lung involvement were observed by CT scan of the chest for eight patients. The median delay between drug discontinuation and remission was 6 (range 1-11) months for clinical signs and 6 (range 2-12) months for biological and radiographic findings. Improvement was observed in all patients after drug discontinuation with or without steroids. CONCLUSIONS: Sarcoid-like granulomatosis is rare but not exceptional in patients treated with TNF blockers (approximately 1/2800) and does not seem to be related to gender, rheumatic disease or in our series the type of anti-TNF drug used (monoclonal antibodies or soluble receptor). Discontinuation of anti-TNF usually leads to recovery. |
| Databáze: | OpenAIRE |
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