Etanercept-induced Henoch-Schönlein purpura in a patient with ankylosing spondylitis.
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton. Extra-articular manifestations are less common relative to other rheumatic diseases, and vasculitic complications typically involve the ascending aorta and aortic valve. The use of tumor necrosis factor inhibitors is efficacious in the treatment of patients with AS. Since their routine use, however, tumor necrosis factor inhibitors have been associated with the development of drug-induced complications including the induction of lupus and both cutaneous and systemic vasculitis. In this report, we describe a patient with severe longstanding AS, who developed Henoch-Schönlein purpura after commencing therapy with etanercept. Tumor necrosis factor inhibitor-induced Henoch-Schönlein purpura has been very rarely reported and has been mostly recognized in patients with rheumatoid arthritis.
Roger Williams Medical Center, Boston University School of Medicine, Roger Williams Medical Center, Providence, RI, USA. anishka.rolle@gmail.com
Anishka S
AS
Rolle
Bernard
B
Zimmermann
Sam H
SH
Poon
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D000068800:Etanercept; D005455:Fluorescent Antibody Technique; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011695:IgA Vasculitis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D011241:Prednisone