BMJ Case Reports 2015; doi:10.1136/bcr-2014-207323

Adalimumab-induced lupus serositis

  1. Michael Henry
  1. Department of Respiratory Medicine, Cork University Hospital and School of Medicine, Cork, Ireland
  1. Correspondence to Dr Dearbhla Kelly, dearbhlakelly2{at}
  • Accepted 9 February 2015
  • Published 4 March 2015


A 61-year-old man presented with a 1-month history of breathlessness, chest pain and lethargy. He had been taking adalimumab for ankylosing spondylitis for 2 years. Pleural and pericardial effusions were both found. A video-assisted thorascopic (VATS) pleural and lung biopsy were performed. The pleural pathology showed eosinophils, acute inflammatory cells and lymphoid aggregates. The patient was positive for antinuclear, antidouble-stranded and antihistone antibodies consistent with drug-induced lupus due to adalimumab. His serositis resolved on withdrawal of the drug. Drug-induced lupus can occur as a consequence of anti-TNF-α agents from induction of autoimmunity in a predisposed host.

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