Rapidly Fatal Pulmonary Fibrosis in a Patient with Psoriatic Arthritis Treated with Adalimumab

Cohen, Justine V.; Capell, Brian C.; Kinniry, Paul; Epstein, Alan L.

doi:10.3899/jrheum.100641

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…However, 5 of our 21 BCS patients (24%) had Crohn's disease where 3 of them were on TNF alpha antagonist treatment. Such association can be explained by the prothrombotic state caused by uncontrolled in ammation during ares in Crohn's disease and perhaps by brosis reported to be related to treatment with anti TNF-α antagonist (23,24) . The later reported to be associated with pulmonary brosis in patients with rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

The Potential Role of Transient Elastography in Assessing Patients with Primary Budd Chiari Syndrome

Webb¹,

Shibolet²,

Lurie³

et al. 2020

JJGH

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Background: Budd-Chiari syndrome (BCS) is a rare disease de ned as hepatic venous out ow obstruction at any level from the hepatic venules up to the cavo-atrial junction. Transjugular Intrahepatic Portosystemic Shunt (TIPS) is performed as a decompressive treatment in some patients.Aim: To evaluate the potential role of Transient Elastography (TE) in assessing liver stiffness in patients with primary BCS. Methods: Twenty one BCS patients and 10 patients with liver cirrhosis with different underlying etiologies underwent abdominal ultrasound and TE.Results: Ninety-ve percent of BCS patients had liver stiffness compatible with F4 with a median of 21 kPa, values which are usually obtained in patients with liver cirrhosis. Ten BCS and 10 cirrhotic patients underwent repeated TE with a median of 320 days between exams for BCS and 4.5 years for cirrhotic patients. The change of liver stiffness in BCS patients was 5.75 kPa (range − 0.4 to 26.6), compared with − 4.85 kPa (range − 15.6 to 15.0) in cirrhotic patients (p-value = 0.0029). Change in liver stiffness from baseline to follow-up in BCS patients who underwent TIPS (n = 4) was 0.2 kPa (range − 0.4 to 15.3), whereas in patients without intervention (n = 6) it was 6.75 kPa (range 1.3 to 26.6). The difference was not statistically signi cant.Conclusion: Liver stiffness in BCS patients is a dynamic progressive process with parameters of TE resembling liver cirrhosis. Even if TIPS seem to slow down the increment of liver stiffness, because of decreased liver congestion, it kept most patients with high score. The TE in BCS patients may be considered for monitoring for stable or upfront disease deterioration.

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Section: Discussionmentioning

confidence: 99%

The Potential Role of Transient Elastography in Assessing Patients with Primary Budd Chiari Syndrome

Webb¹,

Shibolet²,

Lurie³

et al. 2020

JJGH

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“…The sialylated carbohydrate antigen KL‐6, a mucinous high‐molecular weight glycoprotein expressed on type 2 pneumonocytes, is a useful marker for the clinical diagnosis of interstitial lung disease (ILD) and for evaluation of disease activity . The reported sensitivity, specificity and diagnostic accuracy of KL‐6 for interstitial lung diseases are 93.9%, 96.3% and 95.7%, respectively .…”

Section: Reportmentioning

confidence: 99%

“…Serum SP‐A but not SP‐D level was raised in patients 1 and 3, an observation that may indicate this could be a marker of the early phase of ILD. Others have also encountered the development of lung disease in patients with psoriasis treated with anti‐TNF α therapy. Cohen et al .…”

Section: Reportmentioning

confidence: 99%

“…Others have also encountered the development of lung disease in patients with psoriasis treated with anti‐TNF α therapy. Cohen et al . reported fatal pulmonary fibrosis in a patient with PsA treated with ADA.…”

Section: Reportmentioning

confidence: 99%

“…Management of psoriasis has shifted to intensive treatment with biological therapies. Although patients who developed interstitial pneumonia induced by the TNF‐α inhibitors used to treat their rheumatoid arthritis (RA) have been reported, there are few documented patients with psoriasis developing pulmonary disease, including fatal pulmonary fibrosis, induced by TNF‐α inhibitors . No patients with psoriasis and elevation of KL‐6 induced by anti‐TNF‐α drugs have yet been reported.…”

Section: Introductionmentioning

confidence: 99%

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Elevation of serum KL-6 in patients with psoriasis treated with anti-tumour necrosis factor-α therapy

et al. 2014

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We report three patients with psoriasis whose serum level of Krebs Von Den Lungen (KL)-6 increased during therapy with anti-tumour necrosis factor (TNF)-α. A diagnosis of early-phase or subclinical interstitial pneumonia was made in two patients, and their KL-6 level decreased after anti-TNF-α discontinuation. The rise in KL-6 in the other patient was attributed to methotrexate. We propose that serum KL-6 should be monitored routinely in patients treated with anti-TNF agents.

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Rare and Emergent Drug-Induced and Iatrogenic Respiratory Conditions: A Guide to Their Recognition and Management

Bonniaud

Camus

2014

Orphan Lung Diseases

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Rapidly Fatal Pulmonary Fibrosis in a Patient with Psoriatic Arthritis Treated with Adalimumab

Cited by 7 publications

References 9 publications

The Potential Role of Transient Elastography in Assessing Patients with Primary Budd Chiari Syndrome

The Potential Role of Transient Elastography in Assessing Patients with Primary Budd Chiari Syndrome

Elevation of serum KL-6 in patients with psoriasis treated with anti-tumour necrosis factor-α therapy

Rare and Emergent Drug-Induced and Iatrogenic Respiratory Conditions: A Guide to Their Recognition and Management

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