title: Aplastic anemia following administration of a tumor necrosis factor-alpha inhibitor.
abstract: Upregulation of tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of several inflammatory conditions, including rheumatoid arthritis. Therapeutic agents such as antibodies or soluble TNF-alpha receptor analogs, which block TNF-alpha activity are a recent addition to the therapeutic armamentarium for the conditions. We describe a patient who developed aplastic anemia complicated by sepsis after receiving etanercept, a TNF-alpha receptor analog, for the treatment of rheumatoid arthritis. Pancytopenia resolved within 3 wk of discontinuing etanercept. To our knowledge, this is the first report of aplastic anemia associated with TNF-alpha blockade.
authors.affiliation: Division of Hematology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Kuruvilla
authors.forename: Heather A
authors.initials: HA
authors.lastname: Leitch
authors.forename: Linda M
authors.initials: LM
authors.lastname: Vickars
authors.forename: Paul F
authors.initials: PF
authors.lastname: Galbraith
authors.forename: Charles H
authors.initials: CH
authors.lastname: Li
authors.forename: Saad
authors.initials: S
authors.lastname: Al-Saab
authors.forename: Sheldon C
authors.initials: SC
authors.lastname: Naiman
mesh_terms: D000368:Aged; D000741:Anemia, Aplastic / Q000139:chemically induced*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004359:Drug Therapy, Combination; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept; D008727:Methotrexate