Etanercept Ameliorates Sarcoidosis Arthritis and Skin Disease

DINESH KHANNA, MICHAEL R. LIEBLING, and JAMES S. LOUIE

ABSTRACT.

Sarcoidosis is a systemic disorder of unknown etiology characterized by its pathological hallmark, the noncaseating granuloma. In granulomatous diseases, the proinflammatory peptide mediators, including tumor necrosis factor-a (TNF-a), are increased in the blood and fluids surrounding the activated macrophages. We describe a patient with chronic sarcoidosis arthropathy and lupus pernio resistant to corticosteroids and disease modifying antirheumatic agents, who responded to the addition of etanercept. We discuss the possible mechanisms of action of anti-TNF agents in granulomatous diseases and suggest that chronic, resistant sarcoidosis requires combination immunosuppressive therapy. (J Rheumatol 2003;30:1864-7)

Key Indexing Terms:

SARCOIDOSIS
ETANERCEPT

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From the Division of Rheumatology, Department of Medicine, UCLA Center for the Health Sciences, Los Angeles; and Harbor–UCLA Medical Center, Torrance, California, USA.

D. Khanna, MD, Instructor, UCLA School of Medicine, Center for the Health Sciences; M.R. Liebling, MD, FACR, Professor, Division of Rheumatology, UCLA School of Medicine, Harbor–UCLA Medical Center; J.S. Louie, MD, FACR, FACP, Professor, Division of Rheumatology, UCLA School of Medicine, Harbor–UCLA Medical Center (Current position: Medical Director for Rheumatology, Amgen Corp., Thousand Oaks, CA).

Address reprint requests to Dr. M.R. Liebling, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 470, Torrance, CA 90509. E-mail: mliebling@rei.edu

Submitted June 6, 2002; revision accepted January 10, 2003.

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