Drug-induced sarcoidosis-like reaction to adalimumab in the oral mucosa of a patient with Crohn's Disease

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-10-01 DOI:10.1016/j.jormas.2023.101543

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Abstract

Background

The drug-induced sarcoidosis-like reaction (DISR) is a condition clinically and pathologically similar to sarcoidosis but is induced by certain drugs. A few cases of DISR associated with the use of TNF-α antagonists have been reported in the literature.

Case report

A 49-year-old female patient with a diagnosis of Crohn's Disease under treatment with adalimumab presented with a 2-month-long ulcerated swelling in the left lower fornix. Histological analysis of the biopsy specimen revealed multiple non-caseating granulomas multinucleated cells and epithelioid macrophages surrounded by lymphocytes. The lesion is under symptomatic control with a topical corticosteroid, and the patient is being monitored for manifestation in other organs and systems.

Conclusion

Lesions of DISR may occur isolated in the oral mucosa. Therefore, this complication must be considered in the differential diagnosis of oral granulomatous lesions in patients under treatment with anti-TNF-α drugs.

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克罗恩病患者口腔黏膜中药物诱导的阿达木单抗结节病样反应。

背景：药物诱导的结节病样反应（DISR）是一种临床和病理上类似于结节病的疾病，但由某些药物诱导。文献中报道了一些与使用TNF-α拮抗剂相关的DISR病例。病例报告：一名49岁的女性患者，诊断为克罗恩病，在阿达木单抗治疗下，左下穹窿出现长达两个月的溃疡性肿胀。活检标本的组织学分析显示多个非干酪化肉芽肿多核细胞和被淋巴细胞包围的上皮样巨噬细胞。局部皮质类固醇对病变进行症状控制，并监测患者在其他器官和系统中的表现。结论：DISR的病变可能发生在口腔黏膜中。因此，在使用抗TNF-α药物治疗的患者的口腔肉芽肿性病变的鉴别诊断中，必须考虑这种并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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