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Tumor necrosis factor-alpha (TNF-α)-blockade-induced hepatic sarcoidosis in psoriatic arthritis (PsA): case report and review of the literature

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Abstract

To study the cytokine profile in a 52 year old woman with psoriasis, PsA, and HCV who developed hepatic sarcoidosis following Etanercept therapy for 7 months. 11 PsA patients on TNF blockers mean disease duration 158.4 (SD 114.5), mean treatment duration 72.1 (SD 42.14) months, 8/11 PsA were on Etanercept and 5 healthy controls were studied. TNF-α, sTNF RI/RII, IFN-α/β/γ, IL-1 α, IL-15, IL-6, VEGF, s IL-1 R, sIL-6 R, IL-12, IL-23, IL-17, Adiponectin, Leptin and EGF were assessed. All PsA and controls tested negative for Quantiferon TB Gold, hepatitis B/C, HIV, ACE level, chest x-ray, liver function test (LFTs). Serologic biomarkers of the subject in comparison to the controls indicate that sTNF RI value was significantly higher; and IL-1 alpha level has a high outlier compared to the 11 PsA patients on TNF blockers. The clinical course, histologic findings, increased levels of s TNF R I and IL-1 α in the subject as compared to the other PsA on TNF blockade and controls, suggest that most likely Etanercept induced inflammatory cytokine imbalance was responsible for inducing hepatic sarcoidosis.

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Authors and Affiliations

  1. Medicine Department, Rheumatology and Gastroenterology Sections and School of Public Health, Louisiana State University Health Sciences Center, New Orleans, USA

    Raquel Cuchacovich, Joseph Hagan, Tahir Khan, Arthur Richert & Luis R. Espinoza

  2. LSU Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA

    Raquel Cuchacovich

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  1. Raquel Cuchacovich
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  2. Joseph Hagan
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  3. Tahir Khan
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  4. Arthur Richert
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  5. Luis R. Espinoza
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Correspondence to Raquel Cuchacovich.

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Cuchacovich, R., Hagan, J., Khan, T. et al. Tumor necrosis factor-alpha (TNF-α)-blockade-induced hepatic sarcoidosis in psoriatic arthritis (PsA): case report and review of the literature. Clin Rheumatol 30, 133–137 (2011). https://doi.org/10.1007/s10067-010-1577-1

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  • DOI: https://doi.org/10.1007/s10067-010-1577-1

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