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Melkersson-Rosenthal syndrome in a patient with psoriatic arthritis receiving etanercept
Abstract:
Melkersson-Rosenthal syndrome is a rare granulomatous neuro-mucocutaneous systemic disease that is characterized by relapsing peripheral facial paralysis, orofacial edema and fissured tongue. The disease etiology is still not well known, but it has been hypothesized that a possible role is played by various causal agents such as infectious diseases, genetic causes, allergic conditions, benign lymphogranulomatosis, various associations with other pathological conditions, particularly with immune-mediated diseases and food contact allergies. In this report we describe the case of a woman, 42 years old, with psoriatic arthritis who developed neurological episodes related to MRS after treatment with anti-TNF therapy. This finding further supports the hypothesis that TNF-alpha blockade, and particularly the use of the TNF-alpha receptor, could trigger the development of granulomatous lesions in predisposed patients. The case we report further sustains the importance for the clinician to take into account this potential adverse event in patients receiving anti-TNF-alpha therapies.
Insights
Melkersson-Rosenthal syndrome (MRS) is a rare condition. Anti-TNF therapy may trigger MRS in predisposed individuals, highlighting a potential adverse event for clinicians to consider.
Area of Science:
- Neuroimmunology
- Dermatology
- Rheumatology
Background:
- Melkersson-Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disease characterized by facial paralysis, orofacial edema, and fissured tongue.
- The exact etiology of MRS remains unknown, with suspected links to infectious, genetic, allergic, and immune-mediated factors.
Observation:
- A 42-year-old woman with psoriatic arthritis developed neurological episodes consistent with MRS.
- These episodes occurred following treatment with anti-tumor necrosis factor (TNF) therapy.
Findings:
- The patient's presentation suggests that TNF-alpha blockade, specifically anti-TNF receptor treatment, may precipitate granulomatous lesions in susceptible individuals.
- This case supports the hypothesis linking TNF-alpha inhibition to the development of MRS.
Implications:
- Clinicians should be aware of the potential for MRS development in patients undergoing anti-TNF-alpha therapies.
- This finding underscores the importance of monitoring for neurological adverse events in patients treated with TNF inhibitors.
