To the Editor:
We read with great interest the article on extraarticular manifestations of rheumatoid arthritis (RA) developing in patients under anti-tumor necrosis factor-α (TNF-α) treatment by Negoescu, et al1. These manifestations were present in 42/152 patients (27.6%), of whom 22/152 (14.5%) were newly diagnosed and 5/152 (3.3%) were worsened preexisting manifestations of lung disease, subcutaneous rheumatoid nodules, and cutaneous vasculitis. One patient had stable chronic renal failure of unclear cause. Conversely, regression of cutaneous nodules was observed in 4 patients, and some patients were in disease remission while others had active disease. This paper raises serious concern for physicians prescribing these biotherapeutic agents, and its results require clarification.
First, with regard to the lung lesions, a wide variety of lung diseases have been described in patients with RA including interstitial lung disease (ILD) and rheumatoid nodules, but also pleural disease, Caplan syndrome, and bronchiectasia2. What were the features of lung lesions in patients in …
Address correspondence to Dr. C. Bachmeyer, Department of Internal Medicine, Tenon Hospital (AP-HP), 4 rue de la Chine, 75020 Paris, France. E-mail: claude.bachmeyer{at}tnn.aphp.fr