Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature.

Abstract

PURPOSE:

To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases.

METHODS:

Review of the clinical records of the authors' patient and of the literature using the PubMed database.

RESULTS:

A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases.

CONCLUSIONS:

Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.

• Authors: Alex Fonollosa, Joseba Artaraz, Iñigo Les, Agustin Martinez-Berriotxoa, Julio Perez Izquierdo, Alberto Saiz Lopez, Jesus Gardeazaba, Barbara Berasategui, Nerea Martinez-Alday
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 20 Issue 1 Pg. 44-8 (Feb 2012) ISSN: 1744-5078 [Electronic] England
• PMID: 22017171 (Publication Type: Case Reports, Letter)

Chemical References

• Immunoglobulin G
• Immunosuppressive Agents
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Etanercept

Topics

• Adult
• Arthritis, Psoriatic (drug therapy)
• Diagnosis, Differential
• Etanercept
• Female
• Follow-Up Studies
• Humans
• Immunoglobulin G (adverse effects, therapeutic use)
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Microscopy, Acoustic
• Receptors, Tumor Necrosis Factor (therapeutic use)
• Sarcoidosis (chemically induced, diagnosis)
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Uveitis, Intermediate (chemically induced, diagnosis)