This report describes a 56-year-old woman who developed granulomatous
lesions consistent with sarcoidosis during adalimumab therapy for
rheumatoid arthritis. Cervical and axillary lymphadenopathy developed
approximately 21 months after adalimumab administration. Non-caseating
epithelioid cell granulomas consistent with sarcoidosis were detected
both in an axillary lymph node specimen and in the bone marrow. Diseases
showing similar histologic changes, especially tuberculosis, were
excluded, and a diagnosis of sarcoidosis was made. Adalimumab was
discontinued, and recovery was observed. The current case is, to our
knowledge, the first to describe adalimumab-induced non-caseating
granulomas in lymph nodes and bone marrow without pulmonary involvement
in a patient treated for rheumatoid arthritis
