Eosinophilia during Psoriasis Treatment with TNF Antagonists

Malisiewicz, Bartosz; Murer, Christian; Schmid, Jana Pachlopnik; French, Lars E.; Schmid‐Grendelmeier, Peter; Navarini, Alexander A.

doi:10.1159/000334805

Cited by 32 publications

(24 citation statements)

References 34 publications

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“…Previous reports have hypothesized that the generation of IgE class-switched antibodies might lead to IgE-mediated drug hypersensitivity and subsequent eosinophilia (10,15,19). Biologics-specific IgE antibodies have been shown to mediate type I hypersensitivity reactions (24).…”

Section: Discussionmentioning

confidence: 99%

“…No marked eosinophilia or skin symptoms were observed in the patient in the year after switching to golimumab. Eosinophilia was previously considered a complication common to all TNF inhibitors, particularly in previous reports describing cases with eosinophilia induced by several TNF inhibitors (9,10,11,15). However, one case report showed that eosinophilia had developed during adalimumab therapy did not reappear after switching to etanercept (10).…”

Section: Discussionmentioning

confidence: 99%

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Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

et al. 2017

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Biologics used in the treatment of rheumatoid arthritis (RA) rarely cause eosinophilia. We herein report a patient with RA being treated with infliximab, adalimumab, and tocilizumab who developed eosinophilia with skin symptoms. Interestingly, the marked eosinophilia and skin symptoms did not reappear after the patient's medication was switched to golimumab. In this case, the presence of biologics-specific antibodies suggested that immunogenicity caused the eosinophilia. Therefore, switching to a biologic with a lower immunogenicity was effective. These findings may be helpful for clinicians treating patients with biologics-induced eosinophilia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

et al. 2017

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“…However, transitioning to adalimumab caused similar eosinophilia. It has been suggested that anti-TNF therapy causes a shift from Th 1 cytokine activity to Th 2 activity, leading to elevated IL5 and resulting in eosinophilia ( 9 ).…”

Section: Conflict Of Interestmentioning

confidence: 99%

Severe Eosinophilic Gastroenteritis in a Crohn’s Disease Patient Treated With Infliximab and Adalimumab

Muir

Surrey

Kriegermeier

et al. 2016

American Journal of Gastroenterology

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“…Bupropion and heparin have been mentioned in sporadic reports of drug-induced eosinophilia with remission following withdrawal [8]. TNF antagonist therapy is also purported to rarely disturb the Th1/Th2 balance [9], one manifestation being asymptomatic hypereosinophilia [10].…”

Section: Isolated Peripheral Blood Eosinophiliamentioning

confidence: 99%

Eosinophilic Drug Allergy

Kuruvilla

Khan

2015

Clinic Rev Allerg Immunol

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While peripheral or tissue eosinophilia may certainly characterize drug eruptions, this feature is hardly pathognomonic for a medication-induced etiology. While delayed drug hypersensitivity reactions with prominent eosinophilic recruitment have been typically classified as type IVb reactions, their pathophysiology is now known to be more complex. Eosinophilic drug reactions have a diversity of presentations and may be benign and self-limited to severe and life-threatening. The extent of clinical involvement is also heterogeneous, ranging from isolated peripheral eosinophilia or single organ involvement (most often the skin and lung) to systemic disease affecting multiple organs, classically exemplified by drug-reaction with eosinophilia and systemic symptoms (DRESS). The spectrum of implicated medications in the causation of DRESS is ever expanding, and multiple factors including drug metabolites, specific HLA alleles, herpes viruses, and immune system activation have been implicated in pathogenesis. Due to this complex interplay of various factors, diagnostic workup in terms of skin and laboratory testing has not been validated. Similarly, the lack of controlled trials limits treatment options. This review also describes other localized as well as systemic manifestations of eosinophilic disease induced by various medication classes, including their individual pathophysiology, diagnosis, and management. Given the multitude of clinical patterns associated with eosinophilic drug allergy, the diagnosis can be challenging. Considerable deficits in our knowledge of these presentations remain, but the potential for severe reactions should be borne in mind in order to facilitate diagnosis and institute appropriate management.

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Eosinophilia during Psoriasis Treatment with TNF Antagonists

Cited by 32 publications

References 34 publications

Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

Successful Switch to Golimumab for Eosinophilia and Skin Symptoms Related to Multiple Biologics in a Patient with Rheumatoid Arthritis

Severe Eosinophilic Gastroenteritis in a Crohn’s Disease Patient Treated With Infliximab and Adalimumab

Eosinophilic Drug Allergy

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