Occurrence of pulmonary rheumatoid nodules following biological therapies

Attila Kovács, Beáta Baksay, Anita Cserenyecz, Klára Molnár, Mária Takács, Z. Szekanecz

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1639-1642
Number of pages4
JournalClinical Rheumatology
Volume34
Issue number9
DOIs
Publication statusPublished - Sep 30 2014

Fingerprint

Rheumatoid Nodule
Biological Therapy
Lung
Joints
Rheumatoid Arthritis
Thorax
X-Rays
Therapeutics
Interleukin-6 Receptors
Antirheumatic Agents
Biological Products
Arthritis
Histology
Lymph Nodes
Biopsy
Neoplasms

Keywords

  • Golimumab
  • Pulmonary rheumatoid nodules
  • Rheumatoid arthritis
  • TNF-α inhibitor
  • Tocilizumab

ASJC Scopus subject areas

  • Rheumatology

Cite this

Occurrence of pulmonary rheumatoid nodules following biological therapies. / Kovács, Attila; Baksay, Beáta; Cserenyecz, Anita; Molnár, Klára; Takács, Mária; Szekanecz, Z.

In: Clinical Rheumatology, Vol. 34, No. 9, 30.09.2014, p. 1639-1642.

Research output: Contribution to journalArticle

Kovács, A, Baksay, B, Cserenyecz, A, Molnár, K, Takács, M & Szekanecz, Z 2014, 'Occurrence of pulmonary rheumatoid nodules following biological therapies', Clinical Rheumatology, vol. 34, no. 9, pp. 1639-1642. https://doi.org/10.1007/s10067-014-2789-6
Kovács, Attila ; Baksay, Beáta ; Cserenyecz, Anita ; Molnár, Klára ; Takács, Mária ; Szekanecz, Z. / Occurrence of pulmonary rheumatoid nodules following biological therapies. In: Clinical Rheumatology. 2014 ; Vol. 34, No. 9. pp. 1639-1642.
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