Pulmonary Sarcoidosis in Behçet's Disease Treated with Adalimumab
KeywordsAdalimumab, pulmonary sarcoidosis, Behcet’s disease, Legionella pneumonia
TNF-? antagonists are used to treat various rheumatic diseases including sarcoidosis. However, there have been increasing reports of sarcoidosis in relation to treatment using these drugs. The pathogenesis of this reaction remains unknown.
This is a report of a clinical case of sarcoidosis in Behçet's disease (DB) with mucocutaneous and intestinal involvement in treatment using adalimumab, with improvement after anti-TNF suspension and corticosteroid therapy.
Sfikakis PP, Markomichelakis N, Alpsoy E, Assaad-Khalil S, Bodaghi B et al. Anti-TNF therapy in the management of Behçet's disease—review and basis for recommendations. Rheumatology 2007;46:736–741.
Vallet H, Riviere S, Sanna A, Deroux A, Moulis G et al. Efficacy of anti-TNF alpha in severe and/or refractory Behçet's disease: multicenter study of 124 patients. J Autoimmun 2015;62:67-74.
Bhargava S, Perlman DM, Allen TL, Ritter JH, Bhargava M. Adalimumab induced pulmonary sarcoid reaction. Respir Med Case Rep 2013;10:53–55.
Hayashi M, Kuraishi H, Masubuchi T, et al. A Fatal Case of Relapsing Pneumonia Caused by Legionella pneumophila in a Patient with Rheumatoid Arthritis After Two Injections of Adalimumab. Clin Med Insights Case 2013;6:101-106.
Tubach F, Ravaud P, Salmon-Ceron D, et al. Emergence of Legionella pneumophila pneumonia in patients receiving tumor necrosis factor-alpha antagonists. Clin Infect Dis 2006;43:e95–100.
Hsin I, Tsai C. Association between sarcoidosis and Behçet disease in a young woman with symptoms mimicking myasthaenia gravis. BMJ Case Rep 2009;2009:10.1136/bcr.09.2008.0874.
Berriche O, Hammami S, Cherif Y, Younes S, Alaya W, Sfar MH. Behçet’s disease and sarcoidosis: a rare association. Research 2014;1:903.
Burns AM, Green PJ, Pasternak S. Etanercept-induced cutaneous and pulmonary sarcoid-like granulomas resolving with adalimumab. J Cutan Pathol 2012;39:289-93.
Gifre L, Ruiz-Esquide V, Xaubet A, Gomez-Puerta JA, Hernandez MV, Sanmarti R. Lung. Sarcoidosis induced by TNF antagonists in rheumatoid arthritis: a case presentation and a literature review. Arch Bronconeumol 2011;47:208–212.
DaÏen CI, Monnier A, Claudepierre P, et al. Sarcoid-like granulomatosis in patients treated with tumor necrosis factor blockers: 10 cases. Rheumatology 2009;48:883.
Issue: Vol. 4 No. 4 (view)