Assuntos
Adalimumab/efeitos adversos , Antirreumáticos/efeitos adversos , Toxidermias/etiologia , Paniculite de Lúpus Eritematoso/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab/uso terapêutico , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Feminino , HumanosAssuntos
Paniculite de Lúpus Eritematoso/induzido quimicamente , Vacinas contra Papillomavirus/efeitos adversos , Adulto , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Paniculite de Lúpus Eritematoso/tratamento farmacológico , Paniculite de Lúpus Eritematoso/imunologiaRESUMO
We report a patient with multiple sclerosis (MS) who developed subcutaneous nodules on the face, shoulders and extremities while being treated with interferon (IFN)-beta-1b. These nodules fluctuated in parallel with myelopathy, and were diagnosed as lupus erythematosus profundus (LEP) based on histopathological findings. The patient showed no relapse of either neurological symptoms or subcutaneous nodules after cessation of IFN-beta-1b. This agent can cause induration and necrosis in the sites of injection but also systemic skin lesions such as LEP ascribable to its immunomodulatory effects.
Assuntos
Interferon beta/efeitos adversos , Esclerose Múltipla/tratamento farmacológico , Paniculite de Lúpus Eritematoso/induzido quimicamente , Gordura Subcutânea/efeitos dos fármacos , Gordura Subcutânea/patologia , Adulto , Quimiotaxia de Leucócito/efeitos dos fármacos , Quimiotaxia de Leucócito/imunologia , Feminino , Humanos , Fatores Imunológicos/efeitos adversos , Interferon beta-1b , Esclerose Múltipla/imunologia , Esclerose Múltipla/fisiopatologia , Paniculite de Lúpus Eritematoso/patologia , Paniculite de Lúpus Eritematoso/fisiopatologia , Gordura Subcutânea/imunologia , Suspensão de TratamentoRESUMO
Even though benefits of vaccination policies have been widely demonstrated, vaccine injections might be associated with rare side effects. In this setting, the potential role of vaccines, mostly against hepatitis B virus, in the induction of autoimmunity has been a matter of controversy. We report the case of a woman followed for a lupus panniculitis which had been in remission for 3 years, who developed a lupus flare following an anti-hepatitis-B vaccine injection. The topography of recurring lupus lesions, the chronology of the flare and the increase in the antinuclear autoantibody serum level all supported a causal role for vaccination in the relapse of the lupus lesions. We believe that the present case might provide a first observation of lupus panniculitis possibly induced by hepatitis B vaccination, and this should be added to the range of dysimmune manifestations caused by vaccinations.
