title: Development of leprosy in a patient with rheumatoid arthritis during treatment with etanercept: a case report.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder. There is a clear association between some disease-modifying drugs used to treat RA and infection. The introduction of the anti-tumor necrosis factor (TNF) therapies has improved the outcome of severe RA. The TNF-antagonism may increase susceptibility to granulomatous pathogens such as Mycobacterium tuberculosis, Listeria monocytogenes, and Histoplasma capsulatum.
  
  
  METHODS
  We report the case of a 37-year-old woman with RA receiving an anti-TNF agent, who developed a rash on her back and both legs, which was finally diagnosed as tuberculoid leprosy.
  
  
  RESULTS
  This is the first case of leprosy due to anti-TNF therapy reported in Europe.
  
  
  CONCLUSIONS
  Clinicians should be aware of this and other types of atypical and serious infections that patients may suffer from when treated with anti-TNF agents.
authors.affiliation: Department of Rheumatology, Hospital Mateu Orfila, Menorca, Spain. paulluch@gmail.com
authors.forename: Pablo
authors.initials: P
authors.lastname: Lluch
authors.forename: Ana
authors.initials: A
authors.lastname: Urruticoechea
authors.forename: Judit
authors.initials: J
authors.lastname: Lluch
authors.forename: María C
authors.initials: MC
authors.lastname: Moll
authors.forename: Manuel
authors.initials: M
authors.lastname: Matos
authors.forename: Josep M
authors.initials: JM
authors.lastname: Benet
authors.forename: Liliana
authors.initials: L
authors.lastname: Ene
authors.forename: Juan D
authors.initials: JD
authors.lastname: Cañete
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003622:Dapsone / Q000627:therapeutic use; D057915:Drug Substitution; D000068800:Etanercept; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000009:adverse effects*; D007917:Leprostatic Agents / Q000627:therapeutic use; D015441:Leprosy, Tuberculoid / Q000188:drug therapy / Q000209:etiology*; D018124:Receptors, Tumor Necrosis Factor; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D028761:Withholding Treatment
chemical_list: D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D007917:Leprostatic Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D003622:Dapsone; D000068800:Etanercept