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New onset systemic lupus erythematosus in a patient receiving etanercept for rheumatoid arthritis
  1. A P Cairns,
  2. M K J Duncan,
  3. A E Hinder,
  4. A J Taggart
  1. Department of Rheumatology, Musgrave Park Hospital, Belfast, Northern Ireland, UK
  1. Correspondence to:
    Dr A Cairns, Department of Rheumatology, Musgrave Park Hospital, Stockman’s Lane, Belfast BT9 7JB, Northern Ireland, UK;
    andrewcairns{at}doctors.org.uk

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The management of severe rheumatoid arthritis (RA) has been revolutionised by the introduction of the biological agents infliximab (Remicade—a chimeric anti-tumour necrosis factor (TNF) α antibody), and etanercept (Enbrel—a soluble TNFα receptor). Both these agents lower the effective level of TNFα, and have been shown to be effective in the management of active RA, either alone (etanercept) or in combination with methotrexate (infliximab).1,2 Full blown drug-induced systemic lupus erythematosus (SLE) has been reported with infliximab,3 but not (until very recently) with etanercept,4 although antinuclear antibodies and autoimmune skin rashes have been reported with etanercept.5,6 We report a case of new onset SLE in a patient receiving etanercept.

CASE REPORT

Treatment of a 51 year old woman with severe seropositive erosive RA with methotrexate, sulfasalazine, Myocrisin (sodium aurothiomalate), d-penicillamine, hydroxychloroquine, and leflunomide had previously failed and she continued to require repeated …

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