ABSTRACT
Anti-tumor necrosis factor drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-tumor necrosis factor drugs is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-tumor necrosis factor drugs and review the current literature. We report two cases of rheumatoid arthritis and a case of ankylosing spondylitis developed idiopathic inflammatory myopathy following anti-tumor necrosis factor therapy. In conclusion, myositis could develop during anti-tumor necrosis factor therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.
Subject(s)
Adalimumab/adverse effects , Antirheumatic Agents/adverse effects , Etanercept/adverse effects , Myositis/chemically induced , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adalimumab/administration & dosage , Adult , Arthritis, Rheumatoid/drug therapy , Etanercept/administration & dosage , Female , Humans , Male , Myositis/diagnosis , Spondylitis, Ankylosing/drug therapy , Young AdultABSTRACT
BACKGROUND: Viruses are common and are involved in the etiology of idiopathic rheumatological diseases. Hepatitis B virus (HBV), a member of the family Hepadnaviridae and hepatitis C virus (HCV), play an important role in the undetermined etiology of arthritis. The clinical manifestations of hepatitis B and C show similarities with various diseases, such as rheumatic diseases. Anti-cyclic citrullinated peptide (anti-CCP) is a specific serological marker for rheumatoid arthritis. OBJECTIVES: The aim of this study was to analyze anti-CCP and rheumatoid factor (RF) levels in patients with a hepatitis B and C infection. MATERIAL AND METHODS: Forty-four patients with hepatitis B, 43 patients with hepatitis C, 25 patients with rheumatoid arthritis, and 46 healthy control serums and their RF and anti-CCP levels were compared. RF was measured by the nephelometer, which detects IgM-RF. Anti-CCP was measured using enzymelinked immunosorbent assay (ELISA) that is included in the second-generation anti-CCP antibody assays (anti-CCP2). RESULTS: The anti-CCP positivity levels were 20.5%, 32.5%, 72.4% and 10.9% for HBV, HCV and RA groups and healthy control group, respectively. When the groups were compared based on their RF positivity and anti-CCP positivity while the values for HBV and HCV group and healthy control group were the same, in RA group there is a significant difference to the rest of the groups (p < 0.01). CONCLUSIONS: Anti-CCP may be positive for HBV and HCV as well, but it is a sensitive and specific immunological marker for RA diagnosis, especially in high-titres.
Subject(s)
Anti-Citrullinated Protein Antibodies/blood , Arthritis, Rheumatoid/blood , Hepatitis B, Chronic/blood , Hepatitis C, Chronic/blood , Rheumatoid Factor/blood , Adult , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/immunology , Biomarkers/blood , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Female , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/immunology , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/immunology , Host-Pathogen Interactions , Humans , Male , Middle Aged , Nephelometry and Turbidimetry , Predictive Value of TestsABSTRACT
Anti-tumor necrosis factor (anti-TNF) drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-TNF is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-TNF and review the current literature. We report two cases of rheumatoid arthritis (RA) and a case of ankylosing spondylitis (AS) developed idiopathic inflammatory myopathy following anti-TNF therapy. In conclusion, myositis could develop during anti-TNF therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.
