Sarcoid-like granulomatosis in patients treated with anti-TNFalpha

peer reviewedOver recent years, anti-TNFalpha have been used to treat rheumatoid arthritis. The principal secondary effect of anti-TNFalpha is tuberculosis infections. Another paradoxical effect, previously less well understood, is the development of sarcoid-like granulomatous reactions. We report the case of a 36 year old woman who had been treated for 9 years with anti-TNF alpha. She developed a pulmonary sarcoid-like gra-nulomatosis, complication that is rare but not exceptional in patients treated with TNF-blockers. Discontinuation of anti TNF usually led to recovery. It has been suggested that these reactions mainly occur with etanercept, but this requires further confirmation