Anti-Tumor Necrosis Factor-α-Induced Systemic Lupus Erythematosus in Patients with Axial Spondiloarthritis-A Single Center Experience
Eastern Journal of Medicine, cilt.29, sa.2, ss.215-221, 2024 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 2
- Basım Tarihi: 2024
- Doi Numarası: 10.5505/ejm.2024.90001
- Dergi Adı: Eastern Journal of Medicine
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.215-221
- Anahtar Kelimeler: Anti-TNF-α induced lupus, Drug-induced lupus erythematosus, Spondyloarthritis, Tumor necrosis factor-α inhibitors
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Lupus induced by a tumor necrosis factor-alpha inhibitor, namely "Anti-TNF-α-Induced Lupus (ATIL)" is commonly seen in patients with Crohn's disease and Rheumatoid Arthritis; however, it is rarely seen in axial spondyloarthropathy (SpA). Here, four cases of ATIL in patients with axial SpA are presented and discussed in the light of literature data. The files of the patients who used anti-TNF-α drugs regularly for at least one year due to axial SpA were reviewed retrospectively, and four patients with ATIL were analysed. ATIL developed while the first case was using Adalimumab for 6 years, the second was using Infliximab for 5 years, the third was using Infliximab for 7 years, and the fourth was using Adalimumab for 16 years. In all cases, antinuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA) values were positive, while none of the cases had hypocomplemen temia. ATIL symptoms were acute mesenteric thrombosis, fever and pleuritis in the first case, arthritis in the small joints of the hand i n the second case, deep vein thrombosis, fever, pleuritis and peritoneal fluid accumulation in the third case and malar rash in the fourth one. Anti-TNF-α medication was discontinued in all patients and prednisolone was started. Only in the third case was the switch to another anti-TNF-α agent. Although anti-TNF-α is an effective and common treatment option in patients wi th SpA, these patients should be carefully monitored for side effects such as ATIL.