title: Successful etanercept therapy for refractory sacroiliitis in a patient with ankylosing spondylitis and mixed connective tissue disease.
abstract: The concurrence of ankylosing spondylitis (AS) in a patient with mixed connective tissue disease (MCTD) is rarely described in the literature. Significant and sustained efficacy with tumor necrosis factor (TNF)-alpha blockers has been demonstrated in AS patients. However, evidence to date has revealed associated side effects, including antinuclear antibody induction and development of a lupus-like syndrome. Several authors have reported lupus-like manifestations in MCTD patients treated with TNF-alpha blockers used to control peripheral polyarthritis. In our case report, we demonstrate a good response to etanercept therapy for refractory sacroiliitis in a patient with coexisting AS and MCTD, without development of a lupus-like syndrome. This demonstrates that etanercept therapy may be an appropriate therapeutic agent for sacroiliitis in MCTD patients, as it is in AS alone.
authors.affiliation: Department of Diagnostic Radiology, College of Medicine, Dankook University, Cheonan, Korea.
authors.forename: Jee Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Hyun Kyu
authors.initials: HK
authors.lastname: Chang
authors.forename: Seong-Kyu
authors.initials: SK
authors.lastname: Kim
mesh_terms: D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012446:Sacroiliac Joint / Q000187:drug effects* / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept