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Current Rheumatology Reviews

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ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

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Case Report

TNF-induced Lupus. A Case-Based Review

Author(s): Anastasia Skalkou, Eleftherios Pelechas, Paraskevi V. Voulgari and Alexandros A. Drosos*

Volume 18, Issue 1, 2022

Published on: 24 November, 2021

Page: [72 - 82] Pages: 11

DOI: 10.2174/1573397117666211102094330

Price: $65

Abstract

Nowadays, tumor necrosis factor-alpha (TNFα) inhibitors have revolutionised the treatment of inflammatory arthritides by demonstrating efficacy with an acceptable toxicity profile. However, autoimmune phenomena and clinical entities have been reported ranging from an isolated presence of autoantibodies to full-blown autoimmune diseases, including drug-induced lupus (DIL).

Case Presentation: A 62-year-old woman with rheumatoid arthritis (RA) refractory to methotrexate and prednisone was treated with adalimumab (ADA). 4 months later, she presented acute cutaneous eruptions after sun exposure, positive ANA (1/640 fine speckled pattern), Ro (SSA) and anti- Smith (Sm) antibodies with no other clinical or laboratory abnormalities. The diagnosis of DIL was made, ADA was discontinued, and she was treated successfully with prednisone plus local calcineurin inhibitors.

Conclusion: Thus, we review the literature for cases of DIL development in patients treated with TNFα inhibitors. Rheumatologists should be aware of the possible adverse events and the requirement of careful clinical evaluation and monitoring.

Keywords: TNF inhibitor, adalimumab, TNF-induced lupus, adverse events, RA, SSA.

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