Toussirot E, Pertuiset E, Kantelip B, Wendling D
Department of Rheumatology, University Hospital Jean Minjoz, Besançon, France.
Clin Exp Rheumatol. 2008 May-Jun;26(3):471-5.
Anti-TNF-alpha agents have been tried in cases of refractory sarcoidosis, giving favourable results. Thus, the occurrence of a granulomatous disease in a patient receiving such drug seems paradoxical. We describe 2 patients with inflammatory rheumatic disease, the first with ankylosing spondylitis, the second with rheumatoid arthritis, under anti-TNF-alpha treatment (infliximab and etanercept respectively) who developed non-caseating granulomas of the lungs and lymph nodes consistent with the diagnosis of sarcoidosis. Limited and various similar cases have been reported. It is generally considered that these granulomatous diseases are related to the anti-TNF-alpha agent.
抗肿瘤坏死因子-α（TNF-α）药物已在难治性结节病病例中试用，并取得了良好效果。因此，在接受此类药物治疗的患者中发生肉芽肿性疾病似乎自相矛盾。我们描述了2例炎性风湿性疾病患者，第一例为强直性脊柱炎，第二例为类风湿关节炎，分别接受抗TNF-α治疗（英夫利昔单抗和依那西普），他们出现了肺部和淋巴结的非干酪样肉芽肿，符合结节病的诊断。已有有限的各种类似病例报道。一般认为这些肉芽肿性疾病与抗TNF-α药物有关。
