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Case Reports
. 2015 Sep;34(9):1639-42.
doi: 10.1007/s10067-014-2789-6. Epub 2014 Sep 30.

Occurrence of pulmonary rheumatoid nodules following biological therapies

Affiliations
Case Reports

Occurrence of pulmonary rheumatoid nodules following biological therapies

Attila Kovács et al. Clin Rheumatol. 2015 Sep.

Abstract

In rheumatoid arthritis (RA), disease activity is generally determined by the joint involvement, but the treatment outcome is often influenced by extra-articular manifestations. Authors present a 74-year-old female patient's case history, who was treated with seropositive RA. Marked disease activity was observed even following combined traditional disease-modifying antirheumatic drug (DMARD) treatment (disease activity score in 28 joints (DAS28) = 6.6). Therefore, the patient received TNF-α antagonist therapy. Golimumab was administered subcutaneous (SC) once monthly which resulted in significant improvement in both clinical and laboratory signs (DAS28 = 3:43). However, the follow-up chest x-ray indicated multiple intrapulmonary foci and enlarged lymph nodes. Biopsies and histology excluded malignancy; rheumatoid nodules were confirmed. Anti-TNF therapy was discontinued and tocilizumab treatment was initiated. The IL-6 receptor inhibitor suppressed arthritic activity, and 2 months later, the follow-up chest x-ray showed a regression of chest nodules. Our cases, as well as reports from other centers, suggest that TNF blockade may induce rheumatoid nodulosis and the use of alternative biologics may be feasible as further treatment of RA.

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References

    1. Curr Rheumatol Rep. 2010 Oct;12(5):379-85 - PubMed
    1. J Rheumatol. 2009 Feb;36(2):437-9 - PubMed
    1. Ann Rheum Dis. 2012 Aug;71(8):1429-31 - PubMed
    1. Mod Rheumatol. 2013 Mar;23(2):393-6 - PubMed
    1. Histol Histopathol. 2011 Mar;26(3):351-6 - PubMed

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