Case Report: Anti–TNF-α therapy–associated destructive thyroiditis and unmasking of latent amyloid A amyloidosis in rheumatoid arthritis

This case highlights that TNF-α inhibition may paradoxically unmask underlying amyloidosis and induce autoimmune thyroiditis. Clinicians should monitor thyroid and systemic amyloid markers when introducing biologic therapy for long-standing RA.

Authors

Noriaki Okumura (ORCID: https://orcid.org/0000-0002-3206-2391)
Takafumi Yayama (ORCID: https://orcid.org/0000-0001-8802-0601)
Shinji Imai (ORCID: https://orcid.org/0000-0002-8629-1691)
Kosuke Kumagai (ORCID: https://orcid.org/0000-0003-4392-9795)
Mitsuhiko Kubo
Tomohiro Mimura

Institutions

Shiga University of Medical Science (JP)
Memorial Hospital (US)

Publication Details

Journal: Frontiers in Immunology
Published: 2026-02-25
DOI: https://doi.org/10.3389/fimmu.2026.1768736
Primary Topic: Amyloidosis: Diagnosis, Treatment, Outcomes
Type: article
Field-Weighted Citation Impact: 0.00

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article

Case Report: Anti–TNF-α therapy–associated destructive thyroiditis and unmasking of latent amyloid A amyloidosis in rheumatoid arthritis

Noriaki Okumura, Takafumi Yayama, Shinji Imai, Kosuke Kumagai et al.

Feb 25, 2026

Frontiers in Immunology

Amyloidosis: Diagnosis, Treatment, Outcomes

article

Case Report: Anti–TNF-α therapy–associated destructive thyroiditis and unmasking of latent amyloid A amyloidosis in rheumatoid arthritis

Noriaki Okumura, Takafumi Yayama, Shinji Imai, Kosuke Kumagai, Mitsuhiko Kubo, Tomohiro Mimura

February 25, 2026article en

Abstract

This case highlights that TNF-α inhibition may paradoxically unmask underlying amyloidosis and induce autoimmune thyroiditis. Clinicians should monitor thyroid and systemic amyloid markers when introducing biologic therapy for long-standing RA.

Frontiers in ImmunologyVol. 17

Shiga University of Medical Science (JP), Memorial Hospital (US)

Good health and well-being

Openalex Percentile: Top 43%

Amyloidosis: Diagnosis, Treatment, Outcomes

DOI Open Access PDF OpenAlex

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