Case Report

Etanercept-Related Extensive Pulmonary Nodulosis in a Patient with Rheumatoid Arthritis

ANNELIES E. van EDE, ALFONS A. den BROEDER, MICHIEL WAGENAAR, PIET L.C.M. van RIEL, and MARJONNE C.W. CREEMERS

ABSTRACT.

Although nodulosis is a common extraarticular manifestation of rheumatoid arthritis, accelerated pulmonary nodulosis is a rare event. The etiology of rheumatoid nodules is still unknown. Nodulosis is not necessarily associated with active joint inflammation, suggesting different pathogenic mechanisms for nodule formation and synovial tissue inflammation. We describe a patient with extensive pulmonary nodulosis, probably related to etanercept treatment. Our case emphasizes the need for careful monitoring for adverse events during treatment with biologicals, especially since the differential diagnosis often includes a broad spectrum of diseases. (First Release June 15 2007; J Rheumatol 2007;34:1590-2)

Key Indexing Terms:

NODULOSIS
RHEUMATOID ARTHRITIS
ETANERCEPT
ANTI-TUMOR NECROSIS FACTOR

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From the Departments of Rheumatology and Pulmonary Medicine, University Medical Centre Nijmegen, Nijmegen, The Netherlands.

A.E. van Ede, MD, PhD; A.A. den Broeder, MD, PhD; P.L.C.M. van Riel, MD, PhD; M.C.W. Creemers, MD, PhD, Department of Rheumatology; M. Wagenaar, MD, Department of Pulmonary Medicine, University Medical Centre Nijmegen.

Address reprint requests to Dr. A.E. van Ede, Department of Rheumatology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: a.brink-vanede@reuma.umcn.nl

Accepted for publication March 27, 2007.

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