Abstract
Anti-tumor necrosis factor (TNF) agents have become central players in the management of autoimmune and rheumatic disease. With the wide use of anti-TNF agents today, we have become aware of rare autoimmune complications as systemic lupus erythematosus and psoriasis, yet rarely has large vessels vasculitis been described. We herein describe a case of cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) (with myeloperoxidase (MPO) antibodies)-associated large vessel vasculitis (aortitis) that developed during anti-TNF treatment for ankylosing spondylitis. Awareness of this rare, but serious, adverse event of these commonly used agents in rheumatic diseases is of importance.
Similar content being viewed by others
References
Sokumbi O et al (2012) Vasculitis associated with tumor necrosis factor-α inhibitors. Mayo Clin Proc 87(8):739–745
Rimar D, Rozenbaum M, Slobodin G, Boulman N, Rosner I (2010) Etanercept related pseudo-empyema in rheumatoid arthritis. Clin Rheumatol 29(5):547–549
Verhoeven F, Bossert M, Lohse-Walliser A, Balblanc JC (2012) Aortitis during etanercept therapy for ankylosing spondylitis: finding the culprit. Joint Bone Spine 79(5):524–526
Mariani N, So A, Aubry-Rozier B (2013) Two cases of Takayasu’s arteritis occurring under anti-TNF therapy. Joint Bone Spine 80(2):211–213
Booth A, Harper L, Hammad T, Bacon P, Griffith M, Levy J, Savage C, Pusey C, Jayne D (2004) Prospective study of TNF alpha blockade with infliximab in anti-neutrophil cytoplasmic antibody-associated systemic vasculitis. J Am Soc Nephrol 15(3):717–721
Lamprecht P, Voswinkel J, Lilienthal T, Nolle B, Heller M, Gross WL, Gause A (2002) Effectiveness of TNF-alpha blockade with infliximab in refractory Wegener’s granulomatosis. Rheumatology (Oxford) 41(11):1303–1307
Stone JH, Uhlfelder ML, Hellmann DB, Crook S, Bedocs NM, Hoffman GS (2001) Etanercept combined with conventional treatment in Wegener’s granulomatosis: a six-month open-label trial to evaluate safety. Arthritis Rheum 44(5):1149–1154
Ramos-Casals M, Brito-Zerón P, Cuadrado MJ, Khamashta MA (2008) Vasculitis induced by tumor necrosis factor-targeted therapies. Curr Rheumatol Rep 10:442–448
Ramos-Casals M, Perez-Alvarez R, Diaz-Lagares C, Cuadrado MJ, Khamashta MA, BIOGEAS Study Group (2010) Autoimmune diseases induced by biological agents A double-edged sword? Autoimmun Rev 9:188–193
De Bandt M, Saint‐Marcoux B (2006) Tumour necrosis factor α blockade and the risk of vasculitis. Ann Rheum Dis 65:1534–1535
Mislav Radić (2011) Drug-induced vasculitis, advances in the etiology, pathogenesis and pathology of vasculitis, Dr. Luis M Amezcua-Guerra (Ed.)
Reitblat T (2013) Appearance of ANCA-associated vasculitis under tumor necrosis factor alpha inhibitors treatment. Am J Case Rep 14:80–82
Ortiz-Sierra MC, Echeverri AF, Tobón GJ, Cañas CA (2014) Developing of granulomatosis with polyangiitis during etanercept therapy. Case Rep Rheumatol 2014:210108
Ashok D, Dubey S, Tomlinson I (2008) C-ANCA positive systemic vasculitis in a patient with rheumatoid arthritis treated with infliximab. Clin Rheumatol 27:261–264
Lautermann D, Braun J Ankylosing spondylitis—cardiac manifestations. Clin Exp Rheumatol 2002; 20(Suppl. 28):S11-S15
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
None.
Rights and permissions
About this article
Cite this article
Ginsberg, S., Rosner, I., Slobodin, G. et al. Etanercept treatment-related c-ANCA-associated large vessel vasculitis. Clin Rheumatol 35, 271–273 (2016). https://doi.org/10.1007/s10067-015-3134-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-015-3134-4