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Pulmonary nodules associated with JAK inhibitor therapy in rheumatoid arthritis: A case report

N Pannell1, D Joseph1, M M T M Ally1

  • 1Department of Internal Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.

African Journal of Thoracic and Critical Care Medicine
|November 11, 2021
PubMed

Insights

Patients on Janus kinase (JAK) inhibitors for rheumatoid arthritis developed lung infections. A case study shows a JAK1 inhibitor led to cryptococcosis, which resolved with antifungal treatment.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) management often involves Janus kinase (JAK) inhibitors.
  • Selective JAK1 inhibitors offer targeted therapy for RA.
  • Understanding potential side effects is crucial for patient safety.

Observation:

  • A patient with RA treated with a selective JAK1 inhibitor developed multiple pulmonary nodules.
  • Imaging revealed cavitation within the nodules.
  • These findings prompted further investigation.

Findings:

  • Biopsies confirmed the presence of cryptococcosis, a fungal infection.
  • The patient's condition was linked to JAK1 inhibitor therapy.
  • Prompt diagnosis and treatment were initiated.

Implications:

  • JAK inhibitors, including selective JAK1 agents, may increase susceptibility to opportunistic infections like cryptococcosis.
  • Pulmonary nodules with cavitation in patients on JAK inhibitors warrant investigation for fungal infections.
  • Effective antifungal therapy can successfully treat these infections, highlighting the importance of vigilant monitoring.
Keywords:
Janus kinase inhibitorsopportunistic infections

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