title: [Infliximab-induced skin reaction with visceral manifestations and high levels of anti-DNA antibodies].
abstract: BACKGROUND
  Infliximab is a monoclonal anti-Tumor Necrosis Factor alpha-antibody (anti-TNFalpha) that has demonstrated its efficacy in the treatment of rheumatoid arthritis, Crohn's disease and psoriasis.
  
  
  METHODS
  We report the case of a 59 year-old woman with a 20-year history of rheumatoid arthritis consulting for an atypical erythematosus rash 18 months after her first infusion of infliximab. The rash was associated with inflammatory syndrome, incipient renal failure and high levels of antinuclear antibodies with the presence of anti-dsDNA antibodies. Lack of specificity in both skin manifestations and histology ruled out a diagnosis of drug-induced lupus. Discontinuation of treatment with infliximab resulted in improvement of all clinical signs together with a significant decrease of antinuclear antibody titers within six months.
  
  
  CONCLUSIONS
  Induction of antinuclear antibodies and/or anti-dsDNA antibodies is often seen in patients treated with TNFalpha inhibitors. Cases of true systemic lupus erythematosus or anti-TNFalpha-related eruption in a context of autoimmunity, as seen in our patient, have been reported only rarely. All cases were reversible upon discontinuation of treatment.
authors: Service de Dermatologie, Hôpital Le Bocage, CHU, Dijon.
authors: G
authors: G
authors: Jeudy
authors: Y
authors: Y
authors: Dutronc
authors: C
authors: C
authors: Galliot-Repkat
authors: J
authors: J
authors: Dupuis
authors: G
authors: G
authors: Jolimoy
authors: D
authors: D
authors: Lambert
authors: E
authors: E
authors: Collet
mesh_terms: D000974:Antibodies, Antinuclear / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D006801:Humans; D007249:Inflammation / Q000139:chemically induced / Q000473:pathology; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000139:chemically induced / Q000473:pathology*
chemical_list: D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D000069285:Infliximab