Year : 2021 | Volume
: 33 | Issue : 2 | Page : 205--208
Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab
Carl Stanley Wilkins1, Kristen Taylor Ashourian2, Ethan Kyle Sobol1, Matthew Fink3, Brian Saltzman4, Steven Teich4
1 Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
2 Department of Ophthalmology, Stroger Eye Clinic/Cook County Health, Chicago, IL, USA
3 Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, USA
4 Icahn School of Medicine at Mount Sinai, New York, NY, USA
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.
Carl Stanley Wilkins
New York Eye and Ear Infirmary Retina Center, 310 East 14th Street, New York, NY
|How to cite this article:|
Wilkins CS, Ashourian KT, Sobol EK, Fink M, Saltzman B, Teich S. Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab.J Curr Ophthalmol 2021;33:205-208
|How to cite this URL:|
Wilkins CS, Ashourian KT, Sobol EK, Fink M, Saltzman B, Teich S. Sarcoid-associated bilateral multifocal choroiditis secondary to adalimumab. J Curr Ophthalmol [serial online] 2021 [cited 2021 Dec 1 ];33:205-208
Available from: http://www.jcurrophthalmol.org/article.asp?issn=2452-2325;year=2021;volume=33;issue=2;spage=205;epage=208;aulast=Wilkins;type=0