Pulmonary sarcoidosis induced by anti–tumor necrosis factor therapy a paradoxical effect

Abstract

Paradoxical effects or reactions to anti–tumor necrosis factor (anti-TNF) therapy are defined by the onset or exacerbation of a certain condition following a treatment regimen for the same condition.1 An increasing number of cases of noninfectious pulmonary granulomatous disease secondary to anti-TNF therapy have been described.2–4 We present here the case of a young woman who was treated with anti-TNF therapy for ankylosing spondylitis and then subsequently developed pulmonary sarcoidosis. In view of the effectiveness of anti-TNF agents in the treatment of sarcoidosis, these cases are also reported to be paradoxical effects.5 Rheumatologists should be aware of the potential for these paradoxical reactions such as sarcoidosis presenting after anti-TNF therapy