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Adalimumab-induced bronchospasm: not a class effect
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  1. R Janssen1,
  2. I Krivokuca2,
  3. A A Kruize3,
  4. L Koenderman2,
  5. J-W J Lammers2
  1. 1
    Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
  2. 2
    Department of Pulmonology, University Medical Centre Utrecht, Utrecht, The Netherlands
  3. 3
    Department of Rheumatology, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Dr R Janssen, Department of Pulmonology, St Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands; r.janssen{at}antonius.net

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A 48-year-old man with rheumatoid arthritis (RA) was admitted with shortness of breath due to bronchospasm and hypoxaemia (Pao2 5.9 kPa (44 mm Hg)). He had no history of pulmonary disease or allergy/atopy. About 3 years before this admission he was treated with infliximab. He was switched from infliximab to etanercept because of its more convenient subcutaneous form of administration. He was switched from etanercept to adalimumab because his RA persistently flared on the former treatment. Three days before admission he had received adalimumab for the second time. Blood count showed a new eosinophilia of 0.8×109/l (normal range 0–0.4). He …

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