Rheumatoid arthritis: a complication of aromatase inhibitor therapy?
We report the case of a 56-year-old woman treated with aromatase inhibitors for a breast cancer. Following one year of such therapy, the patient presented with widespread osteoarthrealgia. The clinical picture worsened 3 years later when the pain became more severe with swelling and stiffness involving several joints in a symmetric fashion. Biochemical analysis showed an increase of ESR, CRP and rheumatoid factor, as well as of anti-CCP antibodies. The x-ray was compatible with a diagnosis of rheumatoid arthritis (RA). Therapy with methotrexate, prednisol one, bisphosphonates and vitamin D was started, achieving a quick clinical remission. Aromatase inhibitors have been shown to alter the distribution of Th1/Th2 lymphocytes and increase the level of RANKL. A possible role of aromatase inhibitors in RA development has been further addressed.
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V
Bruzzese
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Hassan
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A
Zullo
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Zampa
D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D018501:Antirheumatic Agents; D047072:Aromatase Inhibitors