Sarcoid intermediate uveitis following etanercept treatment: a case report and review of the literature.

ABSTRACT

PURPOSE: To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases. METHODS: Review of the clinical records of the authors' patient and of the literature using the PubMed database. RESULTS: A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases. CONCLUSIONS: Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.