Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept

Luis Lora Garcia, MD, served as chief resident of internal medicine at Good Samaritan Hospital, Cincinnati. He currently practices as an internist with Franciscan Physician Network, Michigan City, Ind.

Sneha Centala, MD, MS, is chief resident of internal medicine at TriHealth Good Samaritan Hospital, Cincinnati.

Gitanjali Lobo, MD, is a rheumatology fellow at Oschner Hospital, New Orleans.

Shahla Mallick, MD, is a pulmonary/critical care specialist at TriHealth Good Samaritan Hospital, Cincinnati.

Diana Girnita, MD, PhD, is an assistant professor in the Rheumatology Department at the University of Cincinnati College of Medicine and founder of the telemedicine company Rheumatologist OnCall, Sunnyvale, Calif.

Acknowledgments

The authors are indebted to Charles Perme, MD, who reviewed and selected the radiological images, and to Megan Smith, MD, who provided the pathology image.

References

1. Statement on Sarcoidosis. Joint statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999 Aug;160(2):736–755.
2. Thomas KW, Hunninghake GW. Sarcoidosis. JAMA. 2003 Jun 25;289(24):3300.
3. Callejas-Rubio JL, López-Pérez L, Ortego-Centeno N. Tumor necrosis factor-alpha inhibitor treatment for sarcoidosis. Ther Clin Risk Manag. 2008 Dec;4(6):1305–1313.
4. Massara A, Cavazzini L, La Corte R, Trotta F. Sarcoidosis appearing during anti-tumor necrosis factor α therapy: A new ‘class effect’ paradoxical phenomenon. Two case reports and literature review. Semin Arthritis Rheum. 2010 Feb;39(4):313–319.
5. Sim JK, Lee SY, Shim JJ, Kang KH. Pulmonary sarcoidosis induced by adalimumab: A case report and literature review. Yonsei Med J. 2016 Jan;57(1):272–273.
6. Ungprasert P, Crowson CS, Matteson EL. Epidemiology and clinical characteristics of sarcoidosis: An update from a population-based cohort study from Olmsted County, Minnesota. Reumatismo. 2017 May 22;69(1):16–22.
7. Wu JJ, Schiff KR. Sarcoidosis. Am Fam Physician. 2004 Jul 15;70(2):312–322.
8. Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and management of sarcoidosis. Am Fam Physician. 2016 May 15;93(10):840–848.
9. Durel C-A, Feurer E, Pialat J-B, et al. Etanercept may induce neurosarcoidosis in a patient treated for rheumatoid arthritis. BMC Neurol. 2013 Dec 28;13(1):212.
10. Vieira MAHB, Saraiva MIR, da Silva LKL, et al. Development of exclusively cutaneous sarcoidosis in patient with rheumatoid arthritis during treatment with etanercept. Rev Assoc Méd Bras (1992). 2016 Nov;62(8):718–720.
11. Gifre L, Ruiz-Esquide V, Xaubet A, et al. Lung sarcoidosis induced by TNF antagonists in rheumatoid arthritis: A case presentation and a literature review. Arch Bronconeumol. 2011 Apr;47(4):208–212.
12. Decock A, Van Assche G, Vermeire S, et al. Sarcoidosis-like lesions: Another paradoxical reaction to anti-TNF therapy? J Crohns Colitis. 2017 Mar 1;11(3):378-383.
13. van der Stoep D, Braunstahl G-J, van Zeben J, Wouters J. Sarcoidosis during anti-tumor necrosis factor-alpha therapy: No relapse after rechallenge. J Rheumatol. 2009 Dec;36(12):2847–2848.
14. Bhargava S, Perlman DM, Allen TL, et al. Adalimumab induced pulmonary sarcoid reaction. Respir Med Case Rep. 2013 Oct 26;10:53–55.
15. Celada LJ, Hawkins C, Drake WP. The etiologic role of infectious antigens in sarcoidosis pathogenesis. Clin Chest Med. 2015 Dec;36(4):561–568.
16. Utz JP, Limper AH, Kalra S, et al. Etanercept for the treatment of stage II and III progressive pulmonary sarcoidosis. Chest. 2003 Jul;124(1):177–185.
17. Dinarello CA. Differences between antitumor necrosis factor-alpha monoclonal antibodies and soluble TNF receptors in host defense impairment. J Rheumatol Suppl. 2005 Mar;74:40–47.