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[Onset of modified measles after etanercept treatment in rheumatoid arthritis]

Eigo Takahashi1, Daitaro Kurosaka, Ken Yoshida

  • 1Division of Rheumatology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.

Nihon Rinsho Men'Eki Gakkai Kaishi = Japanese Journal of Clinical Immunology
|March 2, 2010
PubMed

Insights

A 69-year-old woman on etanercept for rheumatoid arthritis developed severe modified measles and bone marrow suppression. This case suggests anti-TNF-alpha therapy may increase measles risk and severity.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Rheumatology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Biologic therapies, such as anti-TNF-alpha agents (e.g., etanercept), are used to manage RA.
  • Immunosuppression from these therapies can increase susceptibility to infections.

Observation:

  • A 69-year-old woman with RA developed fever, anorexia, and rash after starting etanercept and corticosteroids.
  • Initial bacterial infection was suspected, but antibiotic treatment was ineffective.
  • Elevated measles IgG and IgM antibody titers confirmed a diagnosis of modified measles.

Findings:

  • The patient experienced severe leukopenia and bone marrow suppression, attributed to the measles infection.
  • This represents the first reported case of modified measles occurring during anti-TNF-alpha therapy.
  • The measles infection was severe and complicated by bone marrow suppression.

Implications:

  • Anti-TNF-alpha therapy may predispose patients to measles reinfection or atypical presentations.
  • Immunosuppression induced by etanercept could exacerbate measles severity.
  • Clinicians should consider measles in immunocompromised patients presenting with febrile exanthems.

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