CASE REPORTS - Development of sarcoidosis in Enbrel-treated RA patients

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Clin Rheumatol. 2007 Nov;26(11):1969-71. Epub 2007 Mar 6.

Development of sarcoidosis in etanercept-treated rheumatoid arthritis patients.

Verschueren K, Van Essche E, Verschueren P, Taelman V, Westhovens R.

Department of Rheumatology, University Hospitals Leuven, Katholieke

Universiteit Leuven, Leuven, Belgium.

We report two rheumatoid arthritis patients developing sarcoidosis

possibly induced by etanercept. Both women, aged 46 and 53, had

erosive, rheumatoid-factor-positive rheumatoid arthritis (RA) for 7

and 6 years, respectively. The eldest had received infliximab for over

a year with good response, which was stopped because of a perfusion

reaction. She developed a cough and dyspnea after 6 months of

etanercept treatment. The other developed erythema nodosum and a

plaque lesion on the right arm after 1 year of etanercept. Imaging

showed, in both cases, mediastinal adenopathies. Biopsies were

compatible with sarcoidosis. Etanercept withdrawal led to a complete

remission. Recently, there have been reports of noninfectious

granulomatous syndromes in patients receiving etanercept for a variety

of diseases. In our cases, the temporal association with etanercept

therapy and the complete remission after suspension of etanercept

suggest a triggering role of this agent. Possible mechanisms of action

and supporting evidence are discussed.

PMID: 17340045

http://www.ncbi.nlm.nih.gov/pubmed/17340045

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