title: Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?
abstract: Takayasu's arteritis (TA) is a rare granulomatous vasculitic disease. Recently, experimental studies and several case reports have supported the use of anti-tumour necrosis factor (TNF) therapy for severe forms of TA. We report a case of a 58-year-old woman who was followed for spondyloarthritis. Her disease was resistant to non-steroidal anti-inflammatory drugs, and TNF-α blockers were initiated. The patient developed asthaenia and severe back pain. The erythrocyte sedimentation rate was 82 mm and C reactive protein was 192 mg/L. Based on thickened walls of large vessel on MRI, a diagnosis of TA was established. Under corticosteroids and after discontinuation of TNF-α blockers, the patient remained free of symptoms at 8-month follow-up.
authors.affiliation: Department of Rheumatology, Mongi Slim Hospital, La Marsa, Tunisia.
authors.forename: Leila
authors.initials: L
authors.lastname: Souabni
authors.affiliation: Department of Rheumatology, Mongi Slim Hospital, La Marsa, Tunisia.
authors.forename: Kaouther
authors.initials: K
authors.lastname: Ben Abdelghani
authors.affiliation: Department of Rheumatology, Mongi Slim Hospital, La Marsa, Tunisia.
authors.forename: Saoussen
authors.initials: S
authors.lastname: Jradi
authors.affiliation: Department of Rheumatology, Mongi Slim Hospital, La Marsa, Tunisia.
authors.forename: Leith
authors.initials: L
authors.lastname: Zakraoui
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D025241:Spondylarthritis / Q000188:drug therapy*; D013625:Takayasu Arteritis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000097:blood / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D014409:Tumor Necrosis Factor-alpha