Concomitant rheumatoid arthritis and amyotrophic lateral sclerosis: report of two new cases and review of literature.
To describe a rare association between rheumatoid arthritis (RA) and amyotrophic lateral sclerosis (ALS). Two new cases of patients with RA who developed amyotrophic lateral sclerosis (ALS), one receiving anti-TNFα agents, were reported. Only other five cases of this rare association have been previously described in literature. The simultaneous presence of the two diseases represents a difficult diagnostic challenge because RA may mimic some musculoskeletal symptoms of ALS. There is no evidence in favor of a common pathophysiologic mechanism, and thus the possibility of a fortuitous association must be raised. A neurotoxic side effect of various drugs for RA treatment could be considered. Casual or causal association remains a difficult choice. The possibility of a coincidental association must be raised but neurologic side effects of TNFα blockers lead to discussion.
Rheumatology Unit, Department of clinical and experimental medicine, University of Ferrara and Azienda Ospedaliero-Universitaria Sant'Anna Hospital of Ferrara, Corso Giovecca, 203-44100, Ferrara, Italy. melipadovan@yahoo.it
Melissa
M
Padovan
Luisa Maria
LM
Caniatti
Francesco
F
Trotta
Marcello
M
Govoni
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000473:pathology*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D010244:Bulbar Palsy, Progressive / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D000069285:Infliximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
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