title: Leukopenia and thrombocytopenia induced by etanercept: two case reports and literature review.
abstract: Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine, and its excess can lead to severe consequences. Those effects are known to be antagonized by TNF-alpha inhibitors. Etanercept is a fusion protein that inhibits TNF-alpha action. As TNF-alpha regulation is related to cellular differentiation of various cellular types involved in immune response through expression of several other cytokines, it is possible that the use of its inhibitors may cause cytopenia. We report two cases of bicytopenia induced by etanercept. Both cases recovered after drug withdrawal. We discuss the need of introduction of routine laboratorial tests in patients using anti-TNF therapy, in order to identify possible hematological changes.
authors.affiliation: Universidade Federal do Parana – UFPR. valderilio@hotmail.com
authors.forename: Valderílio Feijó
authors.initials: VF
authors.lastname: Azevedo
authors.forename: Marília Barreto Gameiro
authors.initials: MB
authors.lastname: Silva
authors.forename: Débora Karine
authors.initials: DK
authors.lastname: Marinello
authors.forename: Felipe Dunin Dos
authors.initials: FD
authors.lastname: Santos
authors.forename: Guilherme Barreto Gameiro
authors.initials: GB
authors.lastname: Silva
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D007970:Leukopenia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept