Adalimumab (Humira) induced acute lung injury

PATIENT: Male, 78 FINAL DIAGNOSIS: Acute lung injury due to Adalimumab SYMPTOMS: — MEDICATION: Adalimumab CLINICAL PROCEDURE: Intubated and put on mechanical ventilation SPECIALTY: Pulmonology OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Adalimumab is a recombinant human monoclonal antibody that blocks the effects of tumor necrosis factor-alpha. Adalimumab related acute lung injury is a rare form of acute respiratory distress syndrome of possible immune etiology that develops immediately after an infusion. CASE REPORT: We describe a 78 year old, male with no previous cardiac comorbidities, who developed acute lung injury (ALI) within one hour of administration of adalimumab. He was successfully treated with mechanical ventilatory support and adjuvant therapy. CONCLUSIONS: TNFα antagonists are a part of a new and revolutionary treatment for severe and difficult-to-treat autoimmune and inflammatory diseases. This report emphasizes that this fatal complication may occur with use of this drug. Clinicians need to be aware of this condition as prompt recognition and supportive management can prevent unwanted morbidity and mortality.