Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature

Ocul Immunol Inflamm. 2012 Feb;20(1):44-8. doi: 10.3109/09273948.2011.623212. Epub 2011 Oct 21.

Abstract

Purpose: To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases.

Methods: Review of the clinical records of the authors' patient and of the literature using the PubMed database.

Results: A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases.

Conclusions: Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Arthritis, Psoriatic / drug therapy
  • Diagnosis, Differential
  • Etanercept
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin G / adverse effects*
  • Immunoglobulin G / therapeutic use
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Microscopy, Acoustic
  • Receptors, Tumor Necrosis Factor / therapeutic use
  • Sarcoidosis / chemically induced*
  • Sarcoidosis / diagnosis
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Uveitis, Intermediate / chemically induced*
  • Uveitis, Intermediate / diagnosis

Substances

  • Immunoglobulin G
  • Immunosuppressive Agents
  • Receptors, Tumor Necrosis Factor
  • Tumor Necrosis Factor-alpha
  • Etanercept