Reversible T-large granular lymphocyte expansion and neutropenia associated with adalimumab therapy

Abstract

The tumor necrosis factor (TNF ) inhibitors adalimumab, inXiximab and etanercept, are nowadays widely used in the treatment of rheumatoid arthritis (RA). Side eVects are mostly related to their strong immunosuppressive eVects, resulting in infections, cancer, lymphoma, lupus-like autoimmune disease, liver disease, demyelinating disorders, and hematologic abnormalities, among others [1]. In this paper, we describe a case of prolonged neutropenia post-adalimumab therapy in a setting of reversible T-cell lymphocytosis with an immunophenotype of large granular lymphocytes (LGL).