J Korean Med Sci.  2006 Oct;21(5):946-949. 10.3346/jkms.2006.21.5.946.

Etanercept-Induced Systemic Lupus Erythematosus in a Patient with Rheumatoid Arthritis

• Kang MJ
• Lee YH
• Lee J

• KMID: 1781922
• DOI: http://doi.org/10.3346/jkms.2006.21.5.946

Abstract

Tumor necrosis factor (TNF) is known to play a critical role in the pathogenesis of rheumatoid arthritis (RA). Etanercept is a recombinant soluble fusion protein of TNF type II receptor and IgG, which acts as a specific TNF- antagonist. Anti-TNF-therapy has been an important advance in the treatment of RA. However, induction of autoantibodies in some proportion of patients treated with TNF inhibitors raised concerns for development of systemic autoimmune diseases such as systemic lupus erythematosus (SLE). Although new autoantibody formation is common with anti-TNF therapy, there are only rare reports of overt SLE, most of which manifested without major organ involvement and resolved shortly after discontinuation of the therapy. We describe a 55-yr-old Korean woman who developed overt life threatening SLE complicated by pneumonia and tuberculosis following etanercept treatment for RA. This case is to our knowledge, the first report of etanercept-induced SLE in Korea.

Keyword

Lupus Erythematosus, Systemic; Etanercept; TNFR-Fc fusion protein; Arthritis, Rheumatoid

MeSH Terms

Receptors, Tumor Necrosis Factor
Middle Aged
Lupus Erythematosus, Systemic/*chemically induced
Immunoglobulin G/*adverse effects
Humans
Female
Arthritis, Rheumatoid/*drug therapy
Antirheumatic Agents/*adverse effects

Figure

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  Fig. 1 Chest radiography shows pneumonic consolidation and pulmonary edema in both lung fields

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  Fig. 2 Chest CT shows pneumonic consolidation, pulmonary edema, and pleural effusion or possible pulmonary hemorrhage.

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