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A case of cellulitis causing tissue defect during etanercept therapy
Dulgeroglu Deniz1, Umay Ebru, Bal Ajda
1Department of Physical Therapy and Rehabilitation, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ministry of Health, Huzur mah 1157. sok 13-1/11 Dikmen Ankara Turkey, Ankara, Turkey. denizdulgeroglu@gmail.com
Rheumatology International
|December 19, 2009
Summary
Tumor necrosis factor-alpha (TNF-α) antagonists effectively treat rheumatoid arthritis but can cause infections. This case highlights a severe skin infection, cellulitis, during etanercept treatment in an RA patient.
Area of Science:
- Rheumatology
- Immunology
- Dermatology
Background:
- Tumor necrosis factor-alpha (TNF-α) antagonists are increasingly used for active rheumatoid arthritis (RA) unresponsive to conventional therapies.
- While effective, these biologic agents carry risks including infections, auto-antibody formation, and hypersensitivity reactions.
Observation:
- A 52-year-old woman with a 21-year history of seropositive, erosive, and nodular RA was initiated on anti-TNF-α therapy due to disease activity.
- During etanercept treatment, she developed severe cellulitis, necessitating hospitalization, surgical debridement, and intravenous antibiotics.
Findings:
- The case illustrates a significant skin infection complication associated with TNF-α antagonist therapy in RA management.
- Etanercept, a common TNF-α inhibitor, was implicated in the development of severe cellulitis.
Implications:
- Clinicians should maintain a high index of suspicion for skin infections in RA patients undergoing TNF-α antagonist treatment.
- Prompt recognition and management of infections like cellulitis are crucial for patient safety and treatment continuity.
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