title: Drug-induced lupus-like syndrome in ankylosing spondylitis treated with infliximab.
abstract: Specific antagonists of tumour necrosis factor (TNF-alpha) have rapidly gained popularity for the treatment of rheumatoid arthritis and ankylosing spondylitis (AS). Reported side effects from these agents include drug-induced autoimmune disorders. The monoclonal antibody against TNF-alpha, infliximab, has been associated with induction of systemic lupus erythematosus (SLE) in only one patient with AS in the literature. However, there have been no published reports of drug induced lupus-like syndrome (LLS) with positive anti-histone antibodies. We describe a 59-year-old woman with a 12-year history of refractory axial AS who developed signs and symptoms of LLS during treatment with infliximb with positive antinuclear and anti-histone antibodies. On diagnosis of LLS, infliximab was discontinued and the LLS-related symptoms promptly resolved.
authors.affiliation: Rheumatology and Physical Rehabilitation Department, Military Hospital Mohammed V, Rabat, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Mounach
authors.forename: M
authors.initials: M
authors.lastname: Ghazi
authors.forename: A
authors.initials: A
authors.lastname: Nouijai
authors.forename: I
authors.initials: I
authors.lastname: Ghozlani
authors.forename: L
authors.initials: L
authors.lastname: Achemlal
authors.forename: A
authors.initials: A
authors.lastname: Bezza
authors.forename: A
authors.initials: A
authors.lastname: El Maghraoui
mesh_terms: D000974:Antibodies, Antinuclear / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D005260:Female; D006657:Histones / Q000276:immunology; D006801:Humans; D000069285:Infliximab; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000276:immunology; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D006657:Histones; D000069285:Infliximab