Abstract
A 7-year-old girl with polyarticular type juvenile rheumatoid arthritis (JRA) presented with acute onset of right hip pain with limited range of motion and fever within the past two days. She had received etanercept for more than one year. Percutaneous arthrocentesis was performed and showed a white blood cell count of 84150/μL in the synovial fluid, although the culture showed negative results. The fever and right hip pain completely resolved after antibiotic treatment. Herein, we report the first case of septic monoarthritis of JRA under etanercept treatment.
References
Bouza E, Moya JG, Munoz P (2001) Infections in systemic lupus erythematosus and rheumatoid arthritis. Infect Dis Clin North Am 15:335–361 vii
Elwood RL, Pelszynski MM, Corman LI (2003) Multifocal septic arthritis and osteomyelitis caused by group A Streptococcus in a patient receiving immunomodulating therapy with etanercept. Pediatr Infect Dis J 22:286–288
Margaretten ME, Kohlwes J, Moore D, Bent S (2007) Does this adult patient have septic arthritis? JAMA 297:1478–1488
Chang WS, Chiu NC, Chi H, Li WC, Huang FY (2005) Comparison of the characteristics of culture-negative versus culture-positive septic arthritis in children. J Microbiol Immunol Infect 38:189–193
Lovell DJ, Reiff A, Ilowite NT, Wallace CA, Chon Y, Lin SL, Baumgartner SW, Giannini EH (2008) Safety and efficacy of up to eight years of continuous etanercept therapy in patients with juvenile rheumatoid arthritis. Arthritis Rheum 58:1496–1504
Furst DE, Breedveld FC, Burmester GR, Crofford L, Emery P, Feldman M, Kalden JR, Kavanaugh A, Keystone E, Lipsky PE, Maini RN, Moreland L, Smolen JS, Van De Putte L, Vischer T, Weinblatt M, Weissman M (1999) Access to disease modifying treatments for rheumatoid arthritis patients. Ann Rheum Dis 58(Suppl 1):I129–I130
Furst DE, Breedveld FC, Kalden JR, Smolen JS (1999) Building towards a consensus for the use of tumour necrosis factor blocking agents. Ann Rheum Dis 58:725–726
Furst DE, Keystone E, Maini RN, Smolen JS (1999) Recapitulation of the round-table discussion–assessing the role of anti-tumour necrosis factor therapy in the treatment of rheumatoid arthritis. Rheumatology (Oxford) 38(Suppl 2):50–53
Curtis JR, Patkar N, Xie A, Martin C, Allison JJ, Saag M, Shatin D, Saag KG (2007) Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor alpha antagonists. Arthritis Rheum 56:1125–1133
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lin, KC., Liang, CD., Yang, K.D. et al. Monoarticular septic arthritis in a patient with juvenile rheumatoid arthritis under etanercept treatment. Rheumatol Int 32, 1383–1385 (2012). https://doi.org/10.1007/s00296-010-1459-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-010-1459-5