Elsevier

Joint Bone Spine

Volume 76, Issue 6, December 2009, Pages 718-719
Joint Bone Spine

Letter to the editor
Infliximab induced skin and pulmonary sarcoidosis in a rheumatoid arthritis patient

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Case report

In 1998, polymyalgia rheumatica was diagnosed in a 55-year-old woman. Prednisolone was administered and progressively tapered until discontinuation in March 2003.

Three months later, inflammatory pain relapsed at the shoulders but also at the wrists, the metacarpo- and proximal interphalangeal joints (MCP and PIP) with synovitis as well as flexor and extensor tenosynovitis. ESR = 35 mm per first hour, CRP = 100 mg/l. Rheumatoid factors and anticitrullinated peptide antibodies were negative. Shoulder

Discussion

We describe the first case of infliximab induced skin and pulmonary sarcoidosis in a RA patient. Almost all case reports of anti-TNFα induced sarcoidosis are due to etanercept [5], [6] which is known to induce granulomatous diseases such as Crohn disease [7]. These discrepancies observed between monoclonal antibodies and soluble receptors are potentially linked to their differences in term of mechanism of action. In this regard, anti-TNFα monoclonal antibodies have been shown to induce more

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