CASE REPORT - Humira-induced asthma

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Rheumatology Advance Access originally published online on May 3, 2005

Rheumatology 2005 44(9):1199-1200; doi:10.1093/rheumatology/keh676

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LETTER TO THE EDITOR

Adalimumab-induced asthma

A. N. , M. Wong, A. Zain, G. Panayi1 and B. Kirkham1

Guy's and St ' Foundation Hospital NHS Trust and 1 GKT School of

Medicine, London, UK

SIR, A 51-yr-old lady with a 15-yr history of erosive seropositive

rheumatoid arthritis (RA) was treated with adalimumab, having failed

multiple DMARDs. Prior to this she had no personal or family history

of asthma or atopy and had never smoked.

Within 2 weeks of starting adalimumab she developed a diurnal

bronchial wheeze with shortness of breath. This persisted and was

reported at review 8 weeks later. Pulmonary function tests (PFT)

showed an obstructive pattern, forced expiratory volume in 1 s (FEV1)

reduced by 49% of predicted and a significant bronchodilator response

of 25% improvement in FEV1 (15% improvement indicates reversible

airways disease) (Table 1). A raised transfer coefficient (KCo) of

1.88 mmol/kPa/min/l (117% predicted) was also noted, which is typical

of asthma. A full blood count showed a new eosinophilia of 1.0 x 109/l

(normal range 0.0–0.4) and a raised immunoglobulin E of 384 kU/l

(normal range 0–81).

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Read the rest of the letter here:

http://rheumatology.oxfordjournals.org/cgi/content/full/44/9/1199-a

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Not an MD