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Development of leprosy in a patient with rheumatoid arthritis during treatment with etanercept: a case report

Pablo Lluch1, Ana Urruticoechea, Judit Lluch

  • 1Department of Rheumatology, Hospital Mateu Orfila, Menorca, Spain. paulluch@gmail.com

Seminars in Arthritis and Rheumatism
|May 1, 2012
PubMed
Abstract

Insights

Anti-tumor necrosis factor (TNF) therapy for rheumatoid arthritis (RA) can increase infection risk. A European patient on anti-TNF treatment developed leprosy, highlighting the need for vigilance.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Dermatology

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory condition often treated with disease-modifying drugs.
  • Anti-tumor necrosis factor (TNF) therapies have improved RA outcomes but may increase susceptibility to certain infections.
  • Granulomatous pathogens like Mycobacterium tuberculosis are known risks associated with TNF antagonism.

Observation:

  • A 37-year-old female patient with RA was undergoing treatment with an anti-TNF agent.
  • The patient presented with a rash affecting her back and both legs.
  • The condition was ultimately diagnosed as tuberculoid leprosy.

Findings:

  • This case represents the first reported instance of leprosy associated with anti-TNF therapy in Europe.
  • The development of leprosy occurred in a patient with RA receiving immunosuppressive treatment.

Implications:

  • Clinicians must maintain a high index of suspicion for atypical infections in patients on anti-TNF therapy.
  • Awareness of leprosy as a potential adverse effect of anti-TNF agents is crucial for timely diagnosis and management.
  • This case underscores the importance of monitoring for serious infections during immunosuppressive treatments for RA.

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