Abstract
Targeted inhibition of tumor necrosis factor-α (TNF-α) is an effective therapy in rheumatoid arthritis (RA). In some rare cases, autoimmune phenomena, including drug-induced lupus and vasculitis, is described. However, the immunological mechanisms underlying the development of autoimmunity are unknown. We report 3 patients that developed autoimmune phenomena while in use of TNF-α inhibitor, showing concomitant increase in rheumatoid factor (RF). We hypothesize that the increase in RF several months prior to the occurrence of vasculitis may help identifying other patients at risk for the development of vasculitis secondary to these medications.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adalimumab
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Aged
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Aged, 80 and over
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Antibodies, Monoclonal, Humanized / adverse effects*
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Antirheumatic Agents / adverse effects*
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Arthritis, Rheumatoid / drug therapy*
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Arthritis, Rheumatoid / immunology
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Autoimmunity / immunology
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Drug Substitution
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Drug Therapy, Combination
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Etanercept
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Fatal Outcome
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Female
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Glucocorticoids / therapeutic use
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Humans
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Immunoglobulin G / adverse effects*
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Methylprednisolone / therapeutic use
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Prednisone / therapeutic use
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Receptors, Tumor Necrosis Factor
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Rheumatoid Factor / blood*
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Tumor Necrosis Factor-alpha / antagonists & inhibitors*
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Tumor Necrosis Factor-alpha / immunology
Substances
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Antibodies, Monoclonal, Humanized
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Antirheumatic Agents
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Glucocorticoids
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Immunoglobulin G
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Receptors, Tumor Necrosis Factor
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Tumor Necrosis Factor-alpha
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Rheumatoid Factor
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Adalimumab
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Etanercept
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Prednisone
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Methylprednisolone