Etanercept-induced lupus accompanied by hemophagocytic syndrome

Intern Med. 2011;50(17):1843-8. doi: 10.2169/internalmedicine.50.5430. Epub 2011 Sep 1.

Abstract

Hemophagocytic syndrome (HPS) is a severe, potentially life-threatening disorder characterized by an excessive activation of macrophages, such as may occur in the setting of lupus. A 62-year-old Japanese woman treated with etanercept for rheumatoid arthritis developed persistent fever, cytopenia, coagulopathy, and hyperferritinemia. Simultaneously, lupus-like features including pleuritis, hypocomplementemia, and positive autoantibodies were observed. She was diagnosed with HPS related to etanercept-induced lupus, and underwent immunosuppressive therapy with successful recovery. To our knowledge, this is the first case of etanercept-induced lupus accompanied by HPS. This case suggests that HPS should be considered as a complication during TNF-α inhibitor therapy.

Publication types

  • Case Reports

MeSH terms

  • Etanercept
  • Female
  • Humans
  • Immunoglobulin G / adverse effects*
  • Lupus Erythematosus, Cutaneous / chemically induced*
  • Lupus Erythematosus, Cutaneous / complications
  • Lupus Erythematosus, Cutaneous / diagnosis*
  • Lymphohistiocytosis, Hemophagocytic / chemically induced*
  • Lymphohistiocytosis, Hemophagocytic / complications
  • Lymphohistiocytosis, Hemophagocytic / diagnosis*
  • Receptors, Tumor Necrosis Factor
  • Syndrome

Substances

  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Etanercept