title: Onset of lupus like syndrome in patients with spondyloarthritis treated with anti-TNF-α.
abstract: BACKGROUND
  The anti-TNFα therapy has been since its approval by the FDA, along with nonsteroidal antiinflammatory drugs (NSAIDs), one of the most important therapies for control of spondyloarthritis (SpA). The onset of Lupus Like Syndrome (LLS) has been described in patients with rheumatoid arthritis (RA) treated with anti-TNFα therapy but there is little literature on the occurrence of this entity in patients with SpA.
  
  
  METHODS
  We studied 57 patients with SpA who received more than 1 year of anti-TNFα therapy (infliximab, adalimumab or etanercept). Patients were analyzed for the development of LLS, in addition to measuring ANA levels ≥ 1:160 and Anti-dsDNA (measured by IIF).
  
  
  RESULTS
  In total, 7.01% of patients treated with anti-TNFα had titers of ANA ≥ 1:160, whereas 3.5% of patients had serum levels of dsDNA. However, only one patient (1.75%; n = 1) experienced clinical symptoms of LLS; this was a female patient with a history of psoriatic arthritis.
  
  
  CONCLUSIONS
  The presence of LLS secondary to anti-TNFα therapy in patients with SpA is observed less frequently compared with patients with RA. LLS was only detected in a patient with a history of psoriasis since youth, who developed psoriatic arthritis after 27 years of age and had received anti-TNFα therapy for > 2 years. This may be because LLS is an entity clearly associated with innate immunity, with little central role of B and T cells.
authors.affiliation: Hospital Universitario de Caracas, HUC-UCV, Urb, Los Chaguaramos, Ciudad Universitaria, Caracas 1020, DC, Venezuela. luiskakuro@gmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Puertas-Abreu
authors.forename: Elaudi Rodríguez
authors.initials: ER
authors.lastname: Polanco
authors.forename: Miriam
authors.initials: M
authors.lastname: Azocar
authors.forename: Luis Antonio
authors.initials: LA
authors.lastname: Mundarain
authors.forename: Concepción Morelia
authors.initials: CM
authors.lastname: Nuñez-Sotelo
authors.forename: Rafael
authors.initials: R
authors.lastname: Montaño
authors.forename: Freddy Herrera
authors.initials: FH
authors.lastname: Vivas
authors.forename: Zair Tovar
authors.initials: ZT
authors.lastname: Noguera
authors.forename: Francisco
authors.initials: F
authors.lastname: Marín
authors.forename: Omar
authors.initials: O
authors.lastname: Bellorin
authors.forename: José Gregorio
authors.initials: JG
authors.lastname: Rivas
authors.forename: Eduardo
authors.initials: E
authors.lastname: Toro
authors.forename: Eugenia
authors.initials: E
authors.lastname: Benzaquen
authors.forename: Mayra
authors.initials: M
authors.lastname: Rauseo
authors.forename: Luis Arturo
authors.initials: LA
authors.lastname: Gutiérrez González