Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report
Abstract A 28‐year‐old man with ankylosing spondylitis (AS) who was treated with a tumour necrosis factor‐alpha (TNF‐α) inhibitor, adalimumab, presented with newly detected multiple bilateral pulmonary nodules on chest computed tomography (CT). We suspected bacterial infection, including those cause...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Respirology Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rcr2.1065 |
| _version_ | 1811212390337871872 |
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| author | Eriko Hamada Yoshifumi Yamamoto Yosuke Okuda Kazuhiro Sakaguchi Kentaro Suzuki Yoshiro Kai Maiko Takeda Shigeto Hontsu Motoo Yamauchi Masanori Yoshikawa Noriyoshi Sawabata Chiho Ohbayashi Shigeo Muro |
| author_facet | Eriko Hamada Yoshifumi Yamamoto Yosuke Okuda Kazuhiro Sakaguchi Kentaro Suzuki Yoshiro Kai Maiko Takeda Shigeto Hontsu Motoo Yamauchi Masanori Yoshikawa Noriyoshi Sawabata Chiho Ohbayashi Shigeo Muro |
| author_sort | Eriko Hamada |
| collection | DOAJ |
| description | Abstract A 28‐year‐old man with ankylosing spondylitis (AS) who was treated with a tumour necrosis factor‐alpha (TNF‐α) inhibitor, adalimumab, presented with newly detected multiple bilateral pulmonary nodules on chest computed tomography (CT). We suspected bacterial infection, including those caused by acid‐fast bacilli, or adalimumab‐related condition, such as sarcoidosis. After adalimumab cessation, no resolution of the pulmonary shadows was observed. Moreover, pulmonary cavitation appeared on chest CT at 7 weeks, prompting surgical lung biopsy. Acid‐fast bacteria culture of the lung tissue showed negative results. Pathological examination suggested that confluent granulomas associated with sarcoidosis might have obstructed the blood vessels, causing necrosis and lung cavitation. Consequently, prednisolone was initiated, and these shadows were reduced. After administering anti‐interleukin (IL)‐17A antibody for treatment of AS and prednisolone withdrawal, these shadows were not exacerbated. TNF‐α inhibitor‐induced sarcoidosis could cause cavitary lesions due to vascular invasion of granulomas. |
| first_indexed | 2024-04-12T05:27:32Z |
| format | Article |
| id | doaj.art-fc6350419aa348f6b8c02b50c193b8d2 |
| institution | Directory Open Access Journal |
| issn | 2051-3380 |
| language | English |
| last_indexed | 2024-04-12T05:27:32Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Respirology Case Reports |
| spelling | doaj.art-fc6350419aa348f6b8c02b50c193b8d22022-12-22T03:46:13ZengWileyRespirology Case Reports2051-33802022-12-011012n/an/a10.1002/rcr2.1065Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case reportEriko Hamada0Yoshifumi Yamamoto1Yosuke Okuda2Kazuhiro Sakaguchi3Kentaro Suzuki4Yoshiro Kai5Maiko Takeda6Shigeto Hontsu7Motoo Yamauchi8Masanori Yoshikawa9Noriyoshi Sawabata10Chiho Ohbayashi11Shigeo Muro12Department of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Minami‐Nara General Medical Center Nara JapanDepartment of Respiratory Medicine Minami‐Nara General Medical Center Nara JapanDepartment of Diagnostic Pathology Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanDepartment of Thoracic and Cardiovascular Surgery Nara Medical University Nara JapanDepartment of Diagnostic Pathology Nara Medical University Nara JapanDepartment of Respiratory Medicine Nara Medical University Nara JapanAbstract A 28‐year‐old man with ankylosing spondylitis (AS) who was treated with a tumour necrosis factor‐alpha (TNF‐α) inhibitor, adalimumab, presented with newly detected multiple bilateral pulmonary nodules on chest computed tomography (CT). We suspected bacterial infection, including those caused by acid‐fast bacilli, or adalimumab‐related condition, such as sarcoidosis. After adalimumab cessation, no resolution of the pulmonary shadows was observed. Moreover, pulmonary cavitation appeared on chest CT at 7 weeks, prompting surgical lung biopsy. Acid‐fast bacteria culture of the lung tissue showed negative results. Pathological examination suggested that confluent granulomas associated with sarcoidosis might have obstructed the blood vessels, causing necrosis and lung cavitation. Consequently, prednisolone was initiated, and these shadows were reduced. After administering anti‐interleukin (IL)‐17A antibody for treatment of AS and prednisolone withdrawal, these shadows were not exacerbated. TNF‐α inhibitor‐induced sarcoidosis could cause cavitary lesions due to vascular invasion of granulomas.https://doi.org/10.1002/rcr2.1065adalimumabankylosing spondylitisinterleukin‐17sarcoidosistumour necrosis factor‐alpha |
| spellingShingle | Eriko Hamada Yoshifumi Yamamoto Yosuke Okuda Kazuhiro Sakaguchi Kentaro Suzuki Yoshiro Kai Maiko Takeda Shigeto Hontsu Motoo Yamauchi Masanori Yoshikawa Noriyoshi Sawabata Chiho Ohbayashi Shigeo Muro Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report Respirology Case Reports adalimumab ankylosing spondylitis interleukin‐17 sarcoidosis tumour necrosis factor‐alpha |
| title | Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report |
| title_full | Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report |
| title_fullStr | Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report |
| title_full_unstemmed | Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report |
| title_short | Pulmonary sarcoidosis with a cavitary lesion in the lung caused by a TNF‐α inhibitor: A case report |
| title_sort | pulmonary sarcoidosis with a cavitary lesion in the lung caused by a tnf α inhibitor a case report |
| topic | adalimumab ankylosing spondylitis interleukin‐17 sarcoidosis tumour necrosis factor‐alpha |
| url | https://doi.org/10.1002/rcr2.1065 |
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