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Clin Rheumatol. 2011 Apr;30(4):581-3. doi: 10.1007/s10067-010-1603-3. Epub 2010 Oct 23.

Sarcoid-like granulomatosis in patients treated with anti-TNFα factors. A case report and review of the literature.

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2nd Department of Internal Medicine, Medical School of Athens University, "Hippokration" General Hospital of Athens, Athens, Greece.


This report describes a 56-year-old woman who developed granulomatous lesions consistent with sarcoidosis during adalimumab therapy for rheumatoid arthritis. Cervical and axillary lymphadenopathy developed approximately 21 months after adalimumab administration. Non-caseating epithelioid cell granulomas consistent with sarcoidosis were detected both in an axillary lymph node specimen and in the bone marrow. Diseases showing similar histologic changes, especially tuberculosis, were excluded, and a diagnosis of sarcoidosis was made. Adalimumab was discontinued, and recovery was observed. The current case is, to our knowledge, the first to describe adalimumab-induced non-caseating granulomas in lymph nodes and bone marrow without pulmonary involvement in a patient treated for rheumatoid arthritis.

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