TY - JOUR
T1 - Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab
AU - Wilkins, Carl Stanley
AU - Ashourian, Kristen Taylor
AU - Sobol, Ethan Kyle
AU - Fink, Matthew
AU - Saltzman, Brian
AU - Teich, Steven
N1 - Publisher Copyright:
© 2021 Journal of Current Ophthalmology Published by Wolters Kluwer-Medknow.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Purpose: To report a rare paradoxical development of systemic sarcoidosis in a patient taking adalimumab manifesting as multifocal choroidal infiltrates and seventh nerve palsy. Methods: This was a single patient case report. Results: A 30-year-old man with a history of psoriatic arthritis on adalimumab presented with intermittent fevers and headaches. Initial infectious serology and initial ophthalmic examination were within normal limits. Over the next month, he developed a seventh nerve palsy, unilateral decreased visual acuity, and bilateral multifocal choroidal infiltrates. The patient was diagnosed with systemic sarcoidosis secondary to tumor necrosis factor alpha (TNFα) inhibitor use after a hilar lymph node biopsy. Upon treatment with high-dose oral corticosteroids, the patient's symptoms and choroidal lesions significantly improved. Conclusion: This case report illustrates a rare presentation of ocular, neurologic, and systemic sarcoidosis presenting as a bilateral multifocal choroiditis and seventh nerve paresis in a patient treated with adalimumab. We highlight the importance of obtaining an ophthalmic evaluation in the management of this rare adverse effect of TNFα inhibitors.
AB - Purpose: To report a rare paradoxical development of systemic sarcoidosis in a patient taking adalimumab manifesting as multifocal choroidal infiltrates and seventh nerve palsy. Methods: This was a single patient case report. Results: A 30-year-old man with a history of psoriatic arthritis on adalimumab presented with intermittent fevers and headaches. Initial infectious serology and initial ophthalmic examination were within normal limits. Over the next month, he developed a seventh nerve palsy, unilateral decreased visual acuity, and bilateral multifocal choroidal infiltrates. The patient was diagnosed with systemic sarcoidosis secondary to tumor necrosis factor alpha (TNFα) inhibitor use after a hilar lymph node biopsy. Upon treatment with high-dose oral corticosteroids, the patient's symptoms and choroidal lesions significantly improved. Conclusion: This case report illustrates a rare presentation of ocular, neurologic, and systemic sarcoidosis presenting as a bilateral multifocal choroiditis and seventh nerve paresis in a patient treated with adalimumab. We highlight the importance of obtaining an ophthalmic evaluation in the management of this rare adverse effect of TNFα inhibitors.
KW - Adalimumab
KW - Drug reaction
KW - Multifocal choroiditis
KW - Sarcoidosis
KW - Tumor necrosis factor alpha inhibitor
KW - Uveitis
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U2 - 10.4103/JOCO.JOCO_154_20
DO - 10.4103/JOCO.JOCO_154_20
M3 - Article
AN - SCOPUS:85110294983
SN - 1735-4153
VL - 33
SP - 205
EP - 208
JO - Journal of Current Ophthalmology
JF - Journal of Current Ophthalmology
IS - 2
ER -