The most common of these manifestations is new occurrence or worsening of psoriasis occurring in around 2%–5% of IBD treated with anti-TNF.7 8 But other paradoxical manifestations have been described like uveitis, sarcoidosis.9 10 Paradoxical IBD have also been described in patients treated for rheumatic diseases.11 This evidence concerns the gene TNF and inflammatory bowel disease.