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Leukocytoclastic vasculitis due to etanercept
N A Galaria1, V P Werth, H R Schumacher
1Department of Dermatology, Hospital of the University of Pennsylvania, and the Veterans Administration Hospital, Philadelphia, USA.
The Journal of Rheumatology
|August 24, 2000
Summary
Etanercept, a treatment for rheumatoid arthritis (RA), can cause skin reactions. This report details the first case of leukocytoclastic vasculitis linked to etanercept, which resolved after stopping the medication.
Area of Science:
- Immunology
- Dermatology
- Rheumatology
Background:
- Etanercept is a biologic therapy targeting tumor necrosis factor (TNF) for rheumatoid arthritis (RA).
- Cutaneous adverse reactions, including injection site reactions and urticaria, are known side effects of etanercept, occurring in approximately 5% of patients.
- Severe, deforming RA often requires advanced therapies when initial treatments fail.
Observation:
- A patient with severe, deforming rheumatoid arthritis, refractory to multiple treatments, was initiated on etanercept therapy.
- The patient subsequently developed signs and symptoms consistent with leukocytoclastic vasculitis.
- This represents a previously undocumented cutaneous adverse reaction associated with etanercept use.
Findings:
- The clinical presentation and diagnosis confirmed leukocytoclastic vasculitis in the patient receiving etanercept.
- Discontinuation of etanercept therapy resulted in the complete resolution of the vasculitic symptoms.
- This case suggests a potential causal link between etanercept and the development of leukocytoclastic vasculitis.
Implications:
- Physicians should be aware of leukocytoclastic vasculitis as a rare but serious potential adverse effect of etanercept.
- Early recognition and drug withdrawal may be crucial for managing this side effect.
- Further investigation into the immunopathogenesis of etanercept-induced vasculitis is warranted.