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      Tumor necrosis factor-alpha antagonist-induced sarcoidosis.

      Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
      Antibodies, Monoclonal, adverse effects, therapeutic use, Arthritis, Rheumatoid, drug therapy, Biopsy, Female, Humans, Immunoglobulin G, Lung, pathology, Middle Aged, Receptors, Tumor Necrosis Factor, Sarcoidosis, chemically induced, diagnosis, Sarcoidosis, Pulmonary, Skin, Treatment Outcome, Tumor Necrosis Factor-alpha, antagonists & inhibitors

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          Abstract

          Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Tumor necrosis factor (TNF)-alpha is an important player in granuloma formation, and recent clinical trials have investigated the efficacy of TNF-alpha inhibitors in sarcoidosis. Paradoxically, there are several case reports in the medical literature describing the development of sarcoidosis in patients treated with TNF-alpha inhibitors. We describe 3 cases of TNF-alpha antagonist-induced sarcoidosis: 1 case of pulmonary, ocular and cutaneous sarcoidosis developing in a patient receiving infliximab for erosive rheumatoid arthritis, 1 case of etanercept-induced sarcoidosis in a patient with seronegative rheumatoid arthritis, and 1 case of sarcoidosis developing in a patient receiving etanercept for erosive rheumatoid arthritis. We also provide a brief discussion on the role of TNF alpha in granuloma formation and implications in the use of TNF-alpha antagonists in autoimmune disease.

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