SESSION TITLE: Fellow Case Report Poster - Diffuse Lung Disease II
SESSION TYPE: Affiliate Case Report Poster
PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM
INTRODUCTION: We present a case of a sarcoidosis flare occurring after cessation of a patient’s anti-TNF alpha medication.
CASE PRESENTATION: This is a 45 year old woman with psoriatic arthritis currently on Etanercept. She presented with a new productive cough and fever which improved with azithromycin and discontinuation of Etanercept. In the ensuing two months she had a nonproductive cough, night sweats and fatigue. Chest CT displayed bilateral hilar and mediastinal lymphadenopathy. Weeks later, repeat scan showed progression with new bibasilar nodules. EBUS TBNA of the paratracheal and subcarinal lymph node was done. Cytology revealed non-necrotizing granulomas. Cultures for afb and fungal were negative. Flow cytometry was unremarkable. The patient was diagnosed with pulmonary sarcoidosis. She was ultimately restarted on her Etanercept. Repeat CT Chest after medication reinstitution showed resolution of the nodular parenchymal densities and lymphadenopathy. She has remained on Etanercept without any respiratory or constitutional symptoms and with good control of her psoriatic arthritis.