Vol.21 No.6

Case Report

Recurrent allergic bronchopulmonary aspergillosis in a patient with rheumatoid arthritis treated with etanercept and tocilizumab

Authors

Hidehiro Honda1 , Hiroshi Kida1 , Mitsuhiro Yoshida1 , Tetsuya Tomita2 , Masakazu Fujii3 , Shoichi Ihara1 , Sho Goya1 , Isao Tachibana1 , Ichiro Kawase1

  • Department of Respiratory Medicine, Allergy and Rheumatic Disease, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
  • Department of Orthopaedics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
  • Department of Orthopaedics, Gratia Hospital, 6-14-1 Aomataninishi, Minoo, Osaka, 562-8567, Japan
Received:

30 September 2010

Accepted:

18 March 2011

Published online:

7 April 2011

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Abstract

We report the case of a 68-year-old womanwith Stage III and Class II rheumatoid arthritis (RA) that was resistant to prednisolone, methotrexate, and infliximab. After treatment with etanercept or tocilizumab, suspicious allergic bronchopulmonary aspergillosis (ABPA) repeatedly occurred and then rapidly improved after the withdrawal of each drug. We suspect that administration of etanercept and tocilizumab caused suspicious ABPA in this patient. The relevance to the pathogenesis of ABPA under these biological drugs is also discussed.

Key words

Allergic bronchopulmonary aspergillosis - Etanercept - Tocilizumab