From fibrosis to granuloma: drug induced systemic sarcoidosis-like reaction after rituximab in a patient with primary Sjögren’s syndrome

First report of a systemic sarcoidosis-like reaction with necrotizing granulomas following an anti-CD20 therapy, in a patient with primary Sjögren's syndrome.Recognizing immunotherapy and biological therapies as the possible causative agents of rare and underrecognized adverse effects in patients with rare diseases in the era of biologics.Recognizing necrotizing sarcoid granulomas in the diferential diagnosis of patients with caseous inflammation.