Developing of granulomatous thyroiditis during etanercept therapy.
We describe a 32-year-old man who developed granulomatous thyroiditis (GT) during etanercept therapy for rheumatoid arthritis (RA). Fever and thyroid pain developed 8 months after administration of etanercept. Noncaseating epithelioid cell granulomas consistent with GT were detected in a thyroid biopsy. Tissue staining and cultures for bacteria, mycobacterium, and fungus were all negative. Etanercept therapy was withdrawn and steroids regime was indicated with clinical and laboratory improvement. A month after, the patient developed hypothyroidism and recurrence of RA. A year after, the patient is asymptomatic with rituximab, methotrexate, and levothyroxine therapy. We report a case of GT probably in an etanercept-induced granulomatous reaction context.
Cañas
Carlos A
CA
Unit of Rheumatology, Fundación Valle del Lili, Cra. 98 18-49, Cali, Colombia. ccanas@telesat.com.co
Tobón
Gabriel J
GJ
Arango
Luis G
LG
Guarín
Nora
N
D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D008297:Male; D018124:Receptors, Tumor Necrosis Factor; D013968:Thyroiditis, Subacute / Q000139:chemically induced*
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept