Pulmonary granulomas after tumour necrosis factor alpha antagonist therapy

Tumour necrosis factor α (TNFα) antagonists are an established therapeutic option in Crohn's disease and rheumatoid arthritis. In recently published studies these agents have been used with great success, but little is known about any side effects or long term consequences. They increase the fr...

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Bibliographic Details
Published in:Thorax 2003-03, Vol.58 (3), p.278-279
Main Authors: Vavricka, S R, Wettstein, T, Speich, R, Gaspert, A, Bachli, E B
Format: Article
Language:English
Subjects:
Adalimumab
Aged
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal, Humanized
Antirheumatic Agents - adverse effects
Arthritis, Rheumatoid - drug therapy
Biological and medical sciences
Case Report
Causes of
Complications and side effects
Gangrene
Granuloma
Humans
Infections
Male
Medical sciences
Pathogens
Patients
Pneumology
Pulmonary Fibrosis - chemically induced
pulmonary granulomas
Respiratory system : syndromes and miscellaneous diseases
Tuberculosis
Tumor necrosis factor
Tumor necrosis factor-TNF
tumour necrosis factor α antagonist
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Summary:Tumour necrosis factor α (TNFα) antagonists are an established therapeutic option in Crohn's disease and rheumatoid arthritis. In recently published studies these agents have been used with great success, but little is known about any side effects or long term consequences. They increase the frequency of infections with mycobacteria, where TNFα is thought to be an important host defence factor. We describe one patient who was treated with TNFα antagonists and later developed pulmonary granulomas with caseating necrosis without detection of mycobacteria or any other pathogens. Possible mechanisms involved in this newly recognised side effect are discussed.
ISSN:0040-6376
1468-3296
DOI:10.1136/thorax.58.3.278