{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:33:44Z","timestamp":1785224024125,"version":"3.55.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010607","name":"Universit\u00e0 degli Studi di Perugia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010607","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tumor necrosis factor-alpha (TNF-\u03b1) inhibitors are effective treatments for autoimmune diseases but may cause paradoxical adverse events (PAEs), including sarcoid-like granulomatosis. Etanercept, a soluble TNF receptor fusion protein, has been more frequently associated with this phenomenon compared to monoclonal antibodies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We describe a 61-year-old man with chronic plaque psoriasis on long-term etanercept therapy who developed bilateral visual symptoms. Ophthalmologic evaluation revealed granulomatous panuveitis with retinal vasculitis and macular edema. Imaging and lung biopsy confirmed pulmonary sarcoidosis with non-caseating granulomas. Etanercept was discontinued, and systemic corticosteroids were started. Because of steroid dependence, secukinumab (an IL-17A inhibitor) was introduced, together with an intravitreal dexamethasone implant for refractory macular edema. Over a 4-year follow-up, the patient achieved complete and sustained resolution of ocular inflammation with stable systemic control, without the need for further corticosteroids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates a rare but clinically significant presentation of etanercept-induced sarcoidosis with primary ocular involvement. Unlike typical psoriatic uveitis, the bilateral granulomatous pattern prompted further systemic work-up, which revealed otherwise silent pulmonary disease. To our knowledge, this is the first long-term report of etanercept-induced ocular sarcoidosis successfully managed with secukinumab, which allowed steroid withdrawal. While IL-17A inhibitors are not yet approved for uveitis, available data and our observation suggest a potential role in selected cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Etanercept-induced ocular sarcoidosis is a rare but clinically significant PAE. Prompt recognition and multidisciplinary management are crucial to prevent vision loss. IL-17A inhibition may represent a promising steroid-sparing therapeutic option when TNF-\u03b1 inhibitors are contraindicated or cause paradoxical reactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-025-07759-4","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T22:58:18Z","timestamp":1760741898000},"page":"5123-5128","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Etanercept-induced sarcoidosis presenting with bilateral panuveitis: diagnostic value of ocular signs and therapeutic response to IL-17A inhibition\u2014a case-based review"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0641-1462","authenticated-orcid":false,"given":"Tommaso","family":"Bonifazi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Cerquaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Iaccheri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,18]]},"reference":[{"issue":"2","key":"7759_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000239","volume":"2","author":"\u00c9 Toussirot","year":"2016","unstructured":"Toussirot \u00c9, Aubin F (2016) Paradoxical reactions under TNF-\u03b1 blocking agents and other biological agents given for chronic immune-mediated diseases: an analytical and comprehensive overview. 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