Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab

Kim, Tae Kyun; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Eun, Hyuk Soo

doi:10.3393/ac.2017.33.2.74

Cited by 8 publications

(4 citation statements)

References 13 publications

(12 reference statements)

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“…Thus, whether or not TNF-I can be re-initiated for these patients is important to clarify. Only one CD patient re-initiated the same TNF inhibitor (O-IFX) with no recurrence of sarcoidosis observed [ 8 ]. When expanding target diseases to include rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, spondyloarthropathy, psoriasis, CD, juvenile idiopathic arthritis, SAPHO (synovitis, pustulosis, acne, hyperostosis, osteitis), ulcerative colitis, 25 patients re-initiated TNF-I.…”

Section: Discussionmentioning

confidence: 99%

“…When expanding target diseases to include rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, spondyloarthropathy, psoriasis, CD, juvenile idiopathic arthritis, SAPHO (synovitis, pustulosis, acne, hyperostosis, osteitis), ulcerative colitis, 25 patients re-initiated TNF-I. Of 25 patients, 7 were administered the same TNF-I, and sarcoidosis consequently recurred in 4 cases (57.1%) [ 8 , 11 , 23 , 27 , 39 , 63 ]. Eighteen cases started another TNF-I, and sarcoidosis recurred in 3 cases (16.7%) [ 13 , 27 , 64 – 74 ].…”

Section: Discussionmentioning

confidence: 99%

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Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review

et al. 2021

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Background Inflammatory bowel disease (IBD) is chronic inflammation of the gastrointestinal tract, although its etiology has largely been unclear. Tumor necrosis factor inhibitors (TNF-I) are effective for the treatment. Recently, biosimilars of TNF-I, such as CT-P13, have been developed and are thought to possess equal efficacy and safety to the original TNF-I. Sarcoidosis is also a systemic granulomatous disease of unknown etiology. In steroid-resistant cases of sarcoidosis, TNF-I have been reported effective for achieving resolution. However, the progression of sarcoidosis due to the TNF-I also has been reported. We herein report a case of pulmonary sarcoidosis with a Crohn’s disease (CD) patient developed after a long period administration (15 years) of TNF-I. Case presentations A 37-year-old woman with CD who had been diagnosed at 22 years old had been treated with the TNF-I (original infliximab; O-IFX and infliximab biosimilar; IFX-BS). Fifteen years after starting the TNF-I, she developed a fever and right chest pain. Chest computed tomography (CT) revealed clustered small nodules in both lungs and multiple enlarged hilar lymph nodes. Infectious diseases including tuberculosis were negative. Bronchoscopic examination was performed and the biopsy specimens were obtained. A pathological examination demonstrated noncaseating granulomatous lesions and no malignant findings. TNF-I were discontinued because of the possibility of TNF-I-related sarcoidosis. After having discontinued for four months, her symptoms and the lesions had disappeared completely. Fortunately, despite the discontinuation of TNF-I, she has maintained remission. Conclusions To our knowledge, this is the first case in which sarcoidosis developed after switching from O-IFX to IFX-BS. To clarify the characteristics of the cases with development of sarcoidosis during administration of TNF-I, we searched PubMed and identified 106 cases. When developing an unexplained fever, asthenia, uveitis and skin lesions in patients with TNF-I treatment, sarcoidosis should be suspected. Once the diagnosis of sarcoidosis due to TNF-I was made, the discontinuation of TNF-I and administration of steroid therapy should be executed promptly. When re-starting TNF-I, another TNF-I should be used for disease control. Clinicians should be aware of the possibility of sarcoidosis in patients under anti-TNF therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review

et al. 2021

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“…Другие ингибиторы TNF-α имеют недостаточную доказательную базу [143,144]. Могут быть причиной развития саркоидной реакции [145,146].…”

Section: #альфа-токоферола ацетат (витамин е)unclassified

Sarcoidosis: federal clinical guidelines for diagnosis and treatment

Чучалин

Avdeev

Айсанов

et al. 2022

Pulʹmonologiâ (Mosk.)

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Sarcoidosis is a multi-organ granulomatosis of unknown origin. Modern diagnostic methods allow detecting this disease at an early stage. The absence of specific markers requires a comprehensive approach to diagnosis based on comparison of radiation, clinical, morphological and functional data. The course of sarcoidosis without damage to the respiratory system presents significant difficulties. It is extremely important to understand the time and means of starting Sarcoidosis’s treatment to avoid the early initiation of hormones and cytostatics and, on the other hand, to timely respond to progression and threatening conditions. Methods. Clinical recommendations are based on the analysis of Russian and English publications of the latest sarcoidosis research. The target audience of these clinical guidelines are therapists, general practitioners, pulmonologists, TB doctors, rheumatologists, dermatologists, radiation diagnosticians, immunologists, and clinical pharmacologists. Each thesis-recommendation for diagnosis and treatment is evaluated on an 1 to 5 scale of levels of evidence and an A, B, C scale of the grades of recommendations. The clinical guidelines also contain comments and explanations for the theses-recommendations, diagnostic algorithms, treatment strategies, reference materials on the use of recommended drugs. Conclusion. Current information on epidemiology, clinical manifestations, diagnosis and management strategies for patients with sarcoidosis are covered in the presented clinical guidelines. Approved by the decision of the Scientific and Practical Council of the Ministry of Health of the Russian Federation (2022).

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“…Другие ингибиторы ФНО-α имеют недостаточную доказательную базу[108,109]. Могут быть причиной развития саркоидной реакции[110,112].Уровень убедительности рекомендаций C (уровень достоверности доказательств 5).Антифибротическая терапия.Рекомендуется взрослым (детям прием противопоказан) только при прогрессировании изменений у пациентов с IV лучевой стадией саркоидоза в течение последних 6 месяцев, сходных с идиопатическим лёгочным фиброзом (ИЛФ) (наличие «сотового лёгкого», тракционных бронхоэктазов, формирования участков цирроза, снижение ФЖЕЛ и диффузионной способности лёгких). Стабильные ограниченные фиброзные изменения, не нарастающие с течением времени, не являются показанием для антифибротической терапии.…”

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Difficulties of differential diagnosis of sarcoidosis and lymphoproliferative disease

Rapcun,

Belyaeva

2023

Clinical Medicine and Pharmacology

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Sarcoidosis is a systemic inflammatory disease of unknown origin. It belongs to the group of interstitial lung diseases, difficult to diagnose pathologies that require a multidisciplinary approach. A clinical case of the complexity of differential diagnosis of sarcoidosis and lymphoproliferative disease in a young patient is presented. The role of morphological verification in establishing the final diagnosis is shown.

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Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab

Cited by 8 publications

References 13 publications

Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review

Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review

Sarcoidosis: federal clinical guidelines for diagnosis and treatment

Difficulties of differential diagnosis of sarcoidosis and lymphoproliferative disease

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