Chest
Volume 124, Issue 5, November 2003, Pages 2028-2031
Journal home page for Chest

Selected Reports
Refractory Sarcoidosis Responding to Infliximab*

https://doi.org/10.1378/chest.124.5.2028Get rights and content

Despite aggressive treatment with conventional therapy, sarcoidosis may be progressive and debilitating. Tumor necrosis factor (TNF)-α is critical in the genesis and maintenance of granulomatous inflammation. Agents developed to inhibit TNF-α have been approved to treat rheumatoid arthritis and inflammatory bowel disease with unprecedented success. As such, physicians are increasingly using these agents to treat patients with other inflammatory diseases, including sarcoidosis. We report a case of refractory sarcoidosis, involving the lung, eyes, skin, and heart, which flared despite aggressive therapy. Oculocutaneous sarcoid dramatically improved after treatment with the anti-TNF antibody infliximab.

Section snippets

Case Report

A 50-year-old white woman was referred to our institution in 1997 for management of refractory pulmonary sarcoidosis and uveitis. The diagnosis had been confirmed 8 months prior by transbronchial biopsy. She had been receiving maintenance therapy since that time with 60 mg prednisone daily. At the time of her initial visit in 1997, she had experienced a 60-lb weight gain, worsening hypertension, and glucose intolerance as complications of systemic steroid therapy. Her initial examination

Discussion

We have described a patient with multisystem sarcoidosis, including pulmonary, cutaneous, ocular, and cardiac involvement, that progressed despite aggressive therapy. Her clinical course included multiple exacerbations of the disease and numerous therapeutic side effects. Only after the institution of infliximab therapy, as part of a multidrug regimen, did the oculocutaneous sarcoid resolve. This case illustrates the impact that targeted anticytokine therapy may have on selected patients with

References (18)

There are more references available in the full text version of this article.

Cited by (113)

  • Sarcoidosis

    2019, Journal Francais d'Ophtalmologie
  • Sarcoidosis

    2018, Journal Francais d'Ophtalmologie
  • Idiopathic granulomatous interstitial nephritis responsive to mycophenolate mofetil therapy

    2014, American Journal of Kidney Diseases
    Citation Excerpt :

    Our patient responded well to corticosteroid therapy, but then experienced steroid-induced diabetes mellitus, which led to the use of MMF as a corticosteroid-sparing agent. There have been several promising reports of the use of corticosteroid-sparing agents, such as azathioprine, methotrexate, and infliximab, in patients with systemic sarcoidosis with and without renal involvement.13-18 The potential benefit of MMF in the treatment of systemic sarcoidosis also has been reported.14,19-21

View all citing articles on Scopus
View full text