title: Anti-tumor necrosis factor-alpha therapy-induced vasculitis: case series.
abstract: As experience with anti-tumor necrosis factor (TNF-alpha) therapy increases, there has been the expected emergence of reports on uncommon side effects. Large clinical trials identified the development of autoantibodies and postmarketing surveillance has identified problems including tuberculosis. There have been several case reports of drug-induced systemic lupus erythematosus. We describe eight patients with rheumatoid arthritis treated with anti-TNF therapies who developed presumed vasculitis, with different pathophysiologic causes. We discuss the literature and potential causal mechanisms, including disease activity, the role of autoantibodies, and shifts in T cell responses.
authors.affiliation: Academic Unit of Musculoskeletal Medicine, University of Leeds, Great George Street, Leeds LS1 3EX, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Jarrett
authors.forename: Gaye
authors.initials: G
authors.lastname: Cunnane
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Bingham
authors.forename: Maya H
authors.initials: MH
authors.lastname: Buch
authors.forename: Mark A
authors.initials: MA
authors.lastname: Quinn
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D014657:Vasculitis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept