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Left-sided VATS and biopsies again showed pleural-based non-caseating granulomas with normal lung parenchyma. Having ruled out an active infection and malignant lesions, we diagnosed infliximab-induced pleural granulomas. Infliximab was stopped. The patient continues to do well at 6 years of follow-up. We believe this is the first report of tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas.<jats:italic>P. acnes<\/jats:italic>and cytokine imbalance might be responsible for the pathogenesis of TNF inhibitor-induced granulomas.<\/jats:p>","DOI":"10.1136\/bcr-2017-219883","type":"journal-article","created":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T13:14:40Z","timestamp":1498828480000},"page":"bcr-2017-219883","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas: a rare adverse effect"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-1074","authenticated-orcid":false,"given":"Muhammad 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