Necrotizing fasciitis in a patient treated with etanercept for dermatomyositis.
We first report a case of patient with refractory dermatomyositis (DM) who successfully treated with tumor necrosis factor-alpha blocker, etanercept and developed necrotizing fasciitis (NF) after the use of it. NF was diagnosed early by MRI and managed with antimicrobial therapy and timely debridement of necrotic tissue with favorable outcome. We suggest that etanercept can be a useful therapeutic agent in patients with DM refractory to steroid and immunosuppressive agents and NF may occur in DM in association with etanercept therapy. We also suggest that management strategies for early diagnosis and treatment are needed for this complication.
Choi
Kyoung-Hwa
KH
Department of Internal Medicine, Chonbuk National University Medical School, Chonju, South Korea.
Yoo
Wan-Hee
WH
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D003646:Debridement; D003882:Dermatomyositis / Q000628:therapy*; D000068800:Etanercept; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
Arthritis Rheum. 2000 Oct;43(10):2368-77
11037898
N Engl J Med. 1999 Jan 28;340(4):253-9
9920948
Rheumatology (Oxford). 2002 Jul;41(7):828-9
12096238
J Neurol Sci. 1997 Feb 27;146(1):45-51
9077495
Rheumatology (Oxford). 2002 Jan;41(1):22-6
11792875
Eur Neurol. 2004;52(1):61-3
15240986
Arthritis Rheum. 2005 Sep;52(9):2607-15
16142757
Postgrad Med J. 2002 Jan;78(915):47-8
11796874
Lancet. 2000 Jan 1;355(9197):53-7
10615903
N Engl J Med. 2000 Nov 30;343(22):1586-93
11096165
Rheum Dis Clin North Am. 2002 Nov;28(4):799-822
12506773
Ann Rheum Dis. 2002 Sep;61(9):848-9
12176816
Ann Rheum Dis. 2006 Sep;65(9):1233-6
16476710
Aust N Z J Med. 1997 Feb;27(1):29-34
9079250
Eur Neurol. 2003;50(1):10-5
12824706
Rheumatology (Oxford). 2004 Apr;43(4):524-6
15024139
Arthritis Rheum. 2005 Apr 15;53(2):155-65
15818648
Medicine (Baltimore). 2004 Jan;83(1):35-42
14747766