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Silent thyroiditis associated with etanercept in rheumatoid arthritis
  1. E Andrés1,
  2. F-X Limbach2,
  3. B Goichot1,
  4. J Sibilia2
  1. 1Department of Internal Medicine, University Hospital Strasbourg, France
  2. 2Department of Rheumatology, University Hospital Strasbourg
  1. Correspondence to:
    Professor J Sibilia, Service de Rhumatologie, Avenue Moliére, 67 098 Strasbourg Cedex France;

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In recent years, monoclonal antibodies (infliximab) and a recombinant human tumour necrosis factor receptor (p75)-Fc fusion protein (TNFR:Fc) (etanercept) have been successfully used to treat rheumatoid arthritis (RA).1 These TNF blocking agents are now widely employed in patients with treatment resistant RA. TNF inhibitors are generally well tolerated with <0.5% of patients developing a drug induced lupus syndrome, although 4–16% may develop antibodies to double stranded DNA (dsDNA). Apart from two patients presenting autoimmune skin diseases associated with etanercept (discoid lupus and necrotising vasculitis),2 there are no other reports of well documented autoimmune disease. In this paper we describe the first case of silent …

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