Department of Rheumatology and Clinical Immunology, Kyoto University Hospital, Kyoto City, Kyoto, Japan.
Clin Rheumatol. 2010 May;29(5):563-6. doi: 10.1007/s10067-009-1370-1. Epub 2010 Feb 9.
Antitumor necrosis factor (TNF) therapy has been associated with adverse immunologic events including systemic lupus erythematosus. However, the development of polymyositis (PM)/dermatomyositis (DM) associated with anti-TNF therapy is extremely rare. We experienced a case of a 48-year-old female with rheumatoid arthritis (RA) who had anti-Jo-1 antibodies and interstitial lung disease but no previous history of PM/DM and who developed PM soon after the initiation of etanercept (ETN) therapy for RA. The patient recovered upon withdrawal from ETN and corticosteroid (CS) therapies. Only four reports of PM/DM associated with anti-TNF therapy for RA could be found in the literature. The patients described in three of the four reports were positive for anti-Jo-1 antibodies before the initiation of anti-TNF therapy, and in all the cases, recovery occurred after the cessation of anti-TNF-agent administration and CS therapy. These results suggest a relationship between the onset of PM/DM with anti-Jo-1 antibody and anti-TNF therapy for RA.
抗肿瘤坏死因子(TNF)治疗与包括红斑狼疮在内的免疫相关不良事件有关。然而,抗 TNF 治疗相关的多发性肌炎(PM)/皮肌炎(DM)极为罕见。我们遇到了一例 48 岁女性类风湿关节炎(RA)患者,她有抗 Jo-1 抗体和间质性肺病,但无 PM/DM 既往史,在开始用依那西普(ETN)治疗 RA 后很快出现 PM。患者在停用 ETN 和皮质类固醇(CS)治疗后康复。文献中仅发现 4 例与 RA 抗 TNF 治疗相关的 PM/DM。在这 4 例报告中的 3 例患者在开始抗 TNF 治疗前抗 Jo-1 抗体阳性,所有病例在停止抗 TNF 药物治疗和 CS 治疗后均有缓解。这些结果表明 PM/DM 与抗 Jo-1 抗体和抗 TNF 治疗 RA 之间存在关联。