Baha Ayse, Hanazay Cigdem, Kokturk Nurdan, Turktas Haluk
Gazi University School of Medicine, Department of Pulmonary Medicine, Ankara, Turkey.
J Investig Med High Impact Case Rep. 2015 Mar 9;3(1):2324709615571366. doi: 10.1177/2324709615571366. eCollection 2015 Jan-Mar.
Sarcoidosis is a systemic chronic granulomatous disease of unknown etiology. It predominantly involves the lungs but can affect many organs or tissues in the body, such as the lymphatic system, skin, eyes, and liver. Typical histopathological lesions are noncaseating granulomas in the affected organ or tissue. Indications, type of treatment, and duration of sarcoidosis treatment is currently debated. Despite studies showing that anti-tumor necrosis factor-α (TNF-α) treatment can successfully be used in refractory sarcoidosis, there are some case reports regarding the development of sarcoidosis with these agents. There have been reports of 47 anti-TNF-associated cases of sarcoidosis until 2012. The patient is a 54-year-old Caucasian male. During routine examinations of the patient who had been followed for psoriasis vulgaris for 20 years and who had been on several anti-TNF regimens thereafter, new pulmonary pathologies due to sarcoidosis were detected. We present here a case of sarcoidosis that developed after infliximab treatment and showed obvious radiologic regression with discontinuation of treatment. During anti-TNF treatment, it should be kept in mind that autoimmune and granulomatous diseases may develop and particular care should be given to patient follow-ups.
结节病是一种病因不明的全身性慢性肉芽肿性疾病。它主要累及肺部，但可影响身体的许多器官或组织，如淋巴系统、皮肤、眼睛和肝脏。典型的组织病理学病变是受累器官或组织中的非干酪样肉芽肿。目前，结节病的治疗指征、治疗类型和治疗持续时间仍存在争议。尽管有研究表明抗肿瘤坏死因子-α（TNF-α）治疗可成功用于难治性结节病，但也有一些关于使用这些药物后发生结节病的病例报告。截至2012年，已有47例抗TNF相关结节病病例的报道。该患者是一名54岁的白种男性。在对一名因寻常型银屑病随访20年并在此后接受多种抗TNF治疗方案的患者进行常规检查时，发现了由结节病引起的新的肺部病变。我们在此报告一例英夫利昔单抗治疗后发生的结节病病例，该病例在停药后显示出明显的影像学消退。在抗TNF治疗期间，应牢记可能会发生自身免疫性和肉芽肿性疾病，并且应特别关注患者的随访情况。
