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Published on: February 23, 2014
Pneumococcal meningitis and etanercept--chance or association?
B Killingley1, V Carpenter, K Flanagan
1Department of Infection and Tropical Medicine, Lister Unit, Northwick Park Hospital, Watford Road, London HA1 3UJ, UK. bkillingley@hotmail.com
Abstract:
Rheumatoid arthritis is a severe deforming chronic disease which has major implications for mortality and quality of life. Agents with anti-tumour necrosis factor alpha (TNFalpha) activity are a new modality of therapy, which can significantly reduce the acute inflammation in this condition. However, TNFalpha is a cytokine involved in initiating the protective immune response; consequently, patients receiving this therapy are at increased risk of infection. Etanercept is a recombinant form of the p75 TNF receptor (TNF-RII) dimerised by fusion with a portion of the human IgG1 Fc tail with anti-TNFalpha activity. We report the first case of a patient with rheumatoid arthritis who developed pneumococcal meningitis whilst on etanercept, suggesting a possible association between etanercept and this severe life threatening infection.
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