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Concomitant rheumatoid arthritis and amyotrophic lateral sclerosis: report of two new cases and review of literature

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Abstract

To describe a rare association between rheumatoid arthritis (RA) and amyotrophic lateral sclerosis (ALS). Two new cases of patients with RA who developed amyotrophic lateral sclerosis (ALS), one receiving anti-TNFα agents, were reported. Only other five cases of this rare association have been previously described in literature. The simultaneous presence of the two diseases represents a difficult diagnostic challenge because RA may mimic some musculoskeletal symptoms of ALS. There is no evidence in favor of a common pathophysiologic mechanism, and thus the possibility of a fortuitous association must be raised. A neurotoxic side effect of various drugs for RA treatment could be considered. Casual or causal association remains a difficult choice. The possibility of a coincidental association must be raised but neurologic side effects of TNFα blockers lead to discussion.

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Authors and Affiliations

  1. Rheumatology Unit, Department of clinical and experimental medicine, University of Ferrara and Azienda Ospedaliero-Universitaria Sant’Anna Hospital of Ferrara, Corso Giovecca, 203–44100, Ferrara, Italy

    Melissa Padovan, Francesco Trotta & Marcello Govoni

  2. Neurology Unit, Department of Neurosciences, Azienda Ospedaliero-Universitaria Sant’Anna Hospital of Ferrara, Corso Giovecca, 203–44100, Ferrara, Italy

    Luisa Maria Caniatti

Authors
  1. Melissa Padovan
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  2. Luisa Maria Caniatti
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  3. Francesco Trotta
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  4. Marcello Govoni
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Correspondence to Melissa Padovan.

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Padovan, M., Caniatti, L.M., Trotta, F. et al. Concomitant rheumatoid arthritis and amyotrophic lateral sclerosis: report of two new cases and review of literature. Rheumatol Int 31, 715–719 (2011). https://doi.org/10.1007/s00296-010-1760-3

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  • DOI: https://doi.org/10.1007/s00296-010-1760-3

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