Pulmonary nodulosis and aseptic granulomatous lung disease occurring in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha-blocking agent: a case series
| Autor: | Béatrice Bouvard, J M Berthelot, Le Cri, Daniel Wendling, Edouard Pertuiset, Eric Toussirot, Emmanuelle Lecuyer, José le Noach, Anne Lohse, Philippe Gaudin |
|---|---|
| Přispěvatelé: | 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), Service de Rhumatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon |
| Rok vydání: | 2009 |
| Předmět: |
Lung Diseases
Male Pathology MESH: Antirheumatic Agents MESH: Granuloma Rheumatoid nodule Arthritis Receptors Tumor Necrosis Factor Etanercept MESH: Antibodies Monoclonal Arthritis Rheumatoid MESH: Lung Diseases 0302 clinical medicine Immunology and Allergy 030212 general & internal medicine MESH: Treatment Outcome MESH: Aged MESH: Immunoglobulin G MESH: Arthritis Rheumatoid MESH: Middle Aged Granuloma Antibodies Monoclonal Middle Aged 3. Good health Treatment Outcome [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system Rheumatoid arthritis Antirheumatic Agents Female medicine.symptom medicine.drug Adult medicine.medical_specialty Immunology Antibodies Monoclonal Humanized 03 medical and health sciences Rheumatology Internal medicine Adalimumab medicine Rheumatoid factor Humans Aged 030203 arthritis & rheumatology MESH: Humans business.industry Tumor Necrosis Factor-alpha MESH: Adult medicine.disease MESH: Receptors Tumor Necrosis Factor Dermatology Infliximab MESH: Male MESH: Tumor Necrosis Factor-alpha Immunoglobulin G business MESH: Female |
| Zdroj: | Journal of Rheumatology Journal of Rheumatology, Journal of Rheumatology Publishing Company Limited, 2009, 36 (11), pp.2421-7. ⟨10.3899/jrheum.090030⟩ |
| ISSN: | 0315-162X 1499-2752 |
| DOI: | 10.3899/jrheum.090030⟩ |
| Popis: | Objective.To describe cases of development of pulmonary nodulosis or aseptic granulomatous lung disease in patients with rheumatoid arthritis (RA) receiving anti-tumor necrosis factor-α (TNF-α) therapy.Methods.A call for observation of such cases was sent to members of the French “Club Rhumatismes et Inflammation.” The cases had to occur after introduction of TNF-α-blocking therapy.Results.Eleven cases were examined: 6 patients were treated with etanercept, 2 with infliximab, and 3 with adalimumab. Pulmonary nodular lesions were observed after a mean treatment period of 23.3 ± 15.3 months. Clinical symptoms were observed in 5 cases. Radiographs or computed tomography of the chest showed single or multiple nodular lesions in 10 cases and hilar adenopathies in 1 case. Biopsy of the nodular chest lesions or mediastinal lymphadenopathies were performed in 8 patients, and revealed typical rheumatoid nodules in 4 cases and noncaseating granulomatous lesions in 4 cases. Mycobacterial or opportunistic infections were excluded for all cases. Outcome was favorable for all the patients, with either discontinuation or maintenance of anti-TNF-α treatment.Conclusion.Aseptic pulmonary nodular inflammation corresponding to rheumatoid nodules or noncaseating granulomatous inflammation can occur during anti-TNF-α therapy for RA, mainly etanercept. The mechanism explaining such a reaction is not clear but certainly includes different processes. These cases of pulmonary nodular inflammation generally have a benign course and do not systematically require withdrawal of treatment. |
| Databáze: | OpenAIRE |
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