title: Development of lepromatous leprosy following etanercept treatment for arthritis.
abstract: We present a case of a patient treated with etanercept (TNF-a antagonist) for psoriatic arthritis, who then developed clinical symptoms of lepromatous leprosy. She presented with multiple erythematous plaques on trunk, face and extremities, saddle nose deformity, alopecia, articular deformities of the feet and peroneal neuropathy. The clinical suspicion of Hansen's Disase was confirmed by the biopsy findings (lepromatous leprosy). On further questioning, the patient stated that her father was diagnosed with leprosy 70 years ago and had spent some years in a leper colony in Spinalonga island in Southern Greece in the 1940s. This first report of Hansen's disease after administration of etanercept highlights the need of careful risk assessment of patients for whom antiTNF treatment is planned.
authors.affiliation: 2nd Medical Department, Venizelion General Hospital of Heraklion, Heraklion, Greece. hlydakis@yahoo.gr
authors.forename: Charalampos
authors.initials: C
authors.lastname: Lydakis
authors.forename: Despina
authors.initials: D
authors.lastname: Ioannidou
authors.forename: Irini
authors.initials: I
authors.lastname: Koumpa
authors.forename: Elpida
authors.initials: E
authors.lastname: Giannikaki
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Thalassinos
authors.forename: Eleni
authors.initials: E
authors.lastname: Krasoudaki
authors.forename: Spiros
authors.initials: S
authors.lastname: Miyakis
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007914:Leper Colonies; D007918:Leprosy; D015440:Leprosy, Lepromatous / Q000175:diagnosis* / Q000209:etiology; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept