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Optic neuritis with concurrent etanercept and isoniazid therapy
Raul Noguera-Pons1, Joaquín Borrás-Blasco, Isabel Romero-Crespo
1Rheumatology Section, Hospital General Universitario de Elche, Alicante, Spain.
The Annals of Pharmacotherapy
|November 3, 2005
Summary
This case report highlights optic neuritis in a patient treated with etanercept and isoniazid. Discontinuation of these medications led to improvement, suggesting a possible drug-induced adverse effect.
Area of Science:
- Neuro-ophthalmology
- Rheumatology
- Infectious Diseases
Background:
- A 55-year-old male with rheumatoid arthritis was treated with etanercept and isoniazid for latent tuberculosis.
- The patient had no predisposing factors for optic neuritis or a history of demyelinating disease.
Observation:
- The patient developed blurred vision and was diagnosed with bilateral optic neuritis.
- Brain MRI revealed demyelinating lesions, and the clinical course was consistent with optic neuritis.
Findings:
- A close temporal relationship was observed between the initiation of etanercept and isoniazid therapy and the onset of optic neuritis.
- Discontinuation of both medications resulted in general improvement, with the Naranjo scale indicating a possible link between the drugs and optic neuritis.
Implications:
- Patients on concurrent etanercept and isoniazid require close monitoring for neurological adverse effects.
- Immediate discontinuation of etanercept and isoniazid is recommended if optic neuritis is suspected.