Interstitial Granulomatous Drug Reaction to Adalimumab

Martorell, A.; Balmer, Nicole; Cardona, Luis F Cárdenas; Teague, Daniel J.

doi:10.1097/dad.0b013e3181af21b6

Cited by 17 publications

(9 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our patient, the disappearance of the skin manifestations after adalimumab discontinuation is consistent with other case reports of cutaneous granulomatous dermatitis involving TNFα inhibitors [11,16,17,22,[25][26][27][28][29]. Moreover, a causality assessment of the adverse drug reactions was demonstrated to be probable by using Naranjo adverse drug reaction probability scale, with a total score of 6 (meaning a probable adverse drug reaction) [30].…”

Section: Case Descriptionsupporting

confidence: 70%

“…The implicated drugs included calcium channel blockers, angiotensin converting enzyme inhibitors, beta-blockers, lipid-lowering agents, antihistamines, anticonvulsants and antidepressants. In 2006 Deng, et al described the first such reaction to the TNFα inhibitor adalimumab, and in 2010 Martorell-Calatayud, et al described another similar case [16,17]. Table 1 summarizes the recent case-reports in which RGD (IGD, PNGD, IGDR) were observed in patients with arthritis, receiving various TNF-α inhibitors (Table 1).…”

Section: Case Descriptionmentioning

confidence: 99%

See 1 more Smart Citation

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

Cassone¹

2017

Clin Med Rev Case Rep

View full text Add to dashboard Cite

Tumor Necrosis Factor (TNF)-α blockers have been shown to be highly effective in the treatment of arthritis not responsive to traditional therapy. In parallel, there are an increasing number of reports about the development of cutaneous side effects after the administration of anti-TNF-α agents. Noninfectious cutaneous granulomatous reactions include granuloma annulare, non-caseating granuloma, sarcoid-like granulomatosis and also a wide spectrum of conditions recently unified under the term of reactive granulomatous dermatitis.The majority of the above reported granulomatous dermatitis is associated with an underlying inflammatory disorder, and almost all may be drug-induced. Moreover, a substantial overlap, both in clinical and histologic features, is present between these conditions. We describe a reactive granulomatous dermatitis in a patient with psoriatic arthritis treated with adalimumab, resolved after the TNF-α inhibitor discontinuation, and we summarize the recent case-reports in which reactive granulomatous dermatitis were observed in patients with arthritis receiving various TNF-α inhibitors. Reactive granulomatous dermatitis may be a possible long-term side effect of this class of drugs. Although TNF-α blockers are usually used in the treatment of granulomatous disorders, patients treated with these kinds of drugs should be carefully monitored as, in rare cases, TNF-α inhibitors may induce sufficient cytokine activation to support granuloma formation.

show abstract

Section: Case Descriptionsupporting

confidence: 70%

Section: Case Descriptionmentioning

confidence: 99%

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

Cassone¹

2017

Clin Med Rev Case Rep

View full text Add to dashboard Cite

show abstract

“…Apart from the interstitial lymphohistiocytic infiltrate, focal vacuolar degeneration of the basement membrane, necrotic keratinocytes, interstitial eosinophils and mucin may be present [4]. Adalimumab has been reported twice to cause IGDR [4, 5]. …”

Section: Discussionmentioning

confidence: 99%

Interstitial Granulomatous Dermatitis: Another Clinical Variant

et al. 2011

View full text Add to dashboard Cite

A 70-year-old female patient presented with an eruption consisting of symmetrically distributed erythematous papules around the umbilicus 1 month after the cessation of adalimumab for the treatment of rheumatoid arthritis. Biopsy of a papule showed an interstitial granulomatous infiltrate in the dermis, without deposition of mucin. The lesions cleared only after re-initiation of treatment 2 months later. Interstitial granulomatous dermatitis is thought to be a distinct histopathological pattern, either drug induced or associated with rheumatoid arthritis or autoimmune collagen diseases. In our case, there was a distinct clinical presentation of interstitial granulomatous dermatitis, composed of symmetrically distributed indurated papules around the umbilicus as well as a mild granulomatous reaction pattern.

show abstract

“…Subcutaneous injection of enfuvirtide, an antiviral treatment for HIV, results in granuloma formation at the site of injection in a large proportion of patients, as determined by pathological analysis (13, 14). Adalimumab, used in the treatment of rheumatoid arthritis and other autoimmune disorders, is reported to cause lesions and interstitial granulomatous drug reactions (15). Despite these case reports, detailed reports describing the ISR and local tissue response to LAIs are scarce, with minimal characterization of the local cellular and cytokine changes to these responses.…”

Section: Introductionmentioning

confidence: 99%

Long-Acting Atypical Antipsychotics: Characterization of the Local Tissue Response

et al. 2014

View full text Add to dashboard Cite

PurposeLong-acting injectables (LAIs) are increasingly recognized as an effective therapeutic approach for treating chronic conditions. Many LAIs are formulated to create a poorly soluble depot from which the active agent is delivered over time. This long residing depot can cause localized chronic-active inflammation in the tissue, which has not been well defined in the literature. The purpose of this work is to establish an experimental baseline for describing these responses.MethodsNon-human primates and rodents were used to examine the response to LAI formulations of two clinically relevant atypical antipsychotics, aripiprazole monohydrate and olanzapine pamoate monohydrate.ResultsA foreign body response develops with elevations of key cytokines such as IL-1α, IL-1β, TNFα, and IL6 at the site of injection. However, the tissue response for the two atypical antipsychotics compounds diverge as evidenced by quantitative differences observed in cytokine levels at various time points after dosing.ConclusionsOur studies show that, while the drugs are in the same therapeutic class, the response to each of these compounds can be distinguished qualitatively and quantitatively, supporting the idea that the injection site reaction involves a multiplicity of factors including the properties of the compound and cellular dynamics at the site of injection.

show abstract

Interstitial Granulomatous Drug Reaction to Adalimumab

Cited by 17 publications

References 4 publications

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

Interstitial Granulomatous Dermatitis: Another Clinical Variant

Long-Acting Atypical Antipsychotics: Characterization of the Local Tissue Response

Contact Info

Product

Resources

About