{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:29:25Z","timestamp":1786739365772,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To report a rare paradoxical development of systemic sarcoidosis in a patient taking adalimumab manifesting as multifocal choroidal infiltrates and seventh nerve palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a single patient case report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 30-year-old man with a history of psoriatic arthritis on adalimumab presented with intermittent fevers and headaches. Initial infectious serology and initial ophthalmic examination were within normal limits. Over the next month, he developed a seventh nerve palsy, unilateral decreased visual acuity, and bilateral multifocal choroidal infiltrates. The patient was diagnosed with systemic sarcoidosis secondary to tumor necrosis factor alpha (TNF\u03b1) inhibitor use after a hilar lymph node biopsy. Upon treatment with high-dose oral corticosteroids, the patient's symptoms and choroidal lesions significantly improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case report illustrates a rare presentation of ocular, neurologic, and systemic sarcoidosis presenting as a bilateral multifocal choroiditis and seventh nerve paresis in a patient treated with adalimumab. We highlight the importance of obtaining an ophthalmic evaluation in the management of this rare adverse effect of TNF\u03b1 inhibitors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/2452-2325.312161","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T06:19:19Z","timestamp":1626329959000},"page":"205-208","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Sarcoid-Associated Bilateral Multifocal Choroiditis Secondary to Adalimumab"],"prefix":"10.4103","volume":"33","author":[{"given":"Carl Stanley","family":"Wilkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen Taylor","family":"Ashourian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan Kyle","family":"Sobol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Saltzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Teich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20240910","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.5114\/aoms.2014.47827","article-title":"Tumor necrosis factor inhibitors \u2013 State of knowledge","volume":"10","author":"Lis","year":"2014","journal-title":"Arch Med Sci"},{"key":"R2-18-20240910","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1097\/MD.0b013e3181441a68","article-title":"Autoimmune diseases induced by TNF-targeted therapies: Analysis of 233 cases","volume":"86","author":"Ramos-Casals","year":"2007","journal-title":"Medicine (Baltimore"},{"key":"R3-18-20240910","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1093\/rheumatology\/kep046","article-title":"Sarcoid-like granulomatosis in patients treated with tumor necrosis factor blockers: 10 cases","volume":"48","author":"Da\u00efen","year":"2009","journal-title":"Rheumatology (Oxford"},{"key":"R4-18-20240910","first-page":"313","article-title":"Sarcoidosis appearing during anti-tumor necrosis factor \u03b1 therapy: A new \u201cClass Effect\u201d paradoxical phenomenon","volume":"39","author":"Massara","year":"2010","journal-title":"Two case reports and literature review. 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