ABSTRACT
Etanercept is a tumor necrosis factor (TNF) inhibitor that has been used for the treatment of chronic inflammatory diseases including rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Because of its immunosuppressive activity, opportunistic infections have been noted in treated patients, most notably caused by Mycobacterium tuberculosis. Tuberculosis may present in an extrapulmonary or disseminated form. Since TNF-alpha inhibitors have been used in Korea, a few cases of TNF-alpha inhibitor associated tuberculosis have been described. However, tuberculous arthritis has not been previously reported. We describe a case of tuberculous arthritis in a 57-year-old woman with rheumatoid arthritis who was treated with etanercept.
Subject(s)
Female , Humans , Middle Aged , Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/drug therapy , Immunoglobulin G/adverse effects , Receptors, Tumor Necrosis Factor , Tuberculosis, Osteoarticular/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Dermatomyositis is an idiopathic, inflammatory myopathy characterized by proximal muscle weakness and cutaneous lesions. The association of malignancy with dermatomyositis is well established, especially with lung, breast, ovary, stomach, and colorectal cancers. The incidence of cancer appears to be increased especially in elderly person, and the prognosis is very poor. Malignancy may occur before the onset of dermatomyositis, concurrently, or afterward. Therefore extensive screening tests for an occult malignancy should be conducted in patient with dermatomyositis. We report a 76-year-old man presented with dermatomyositis and a search for possible occult malignancy found an otherwise asymptomatic pancreatic adenocarcinoma with massive lymph node metastasis.