Thymic enlargement in a patient with juvenile idiopathic arthritis during etanercept therapy.
Tumor necrosis factor (TNF) alpha inhibitors are effective in the treatment of inflammatory rheumatic diseases. Despite their effectiveness, anti-TNF drugs have some drawbacks such as severe adverse effects including infections and possibly lymphoproliferative disorders. In this report we described a case of juvenile idiopathic arthritis patient who developed thymic enlargement (true thymic hyperplasia), mediastinal lymphadenopathy and pleurisy associated with systemic symptoms under Etanercept treatment. The clinical presentation was highly suggestive of malignancy and the patient underwent diagnostic mediastinoscopy with biopsy.
Sari
Ismail
I
Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Binicier
Omer
O
Birlik
Merih
M
Akar
Servet
S
Yilmaz
Erkan
E
Kargi
Aydanur
A
Onen
Fatos
F
Akkoc
Nurullah
N
D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D003937:Diagnosis, Differential; D000068800:Etanercept; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D007155:Immunologic Factors / Q000009:adverse effects*; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000601:surgery; D008481:Mediastinoscopy; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins / Q000009:adverse effects*; D013950:Thymus Gland / Q000000981:diagnostic imaging / Q000187:drug effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D011993:Recombinant Fusion Proteins; D000068800:Etanercept