Myelitis and optic neuritis induced by a long course of etanercept in a patient with rheumatoid arthritis

A 64-year-old woman presented with an acute onset of myelitis and optic neuritis after 47 months of etanercept use for rheumatoid arthritis. Etanercept was discontinued and pulse methylprednisolone therapy (1000 mg/day for 3 days) was started, followed by a quick and complete resolution. Demyelinati...

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Bibliographic Details
Published in:BMJ case reports 2014-08, Vol.2014, p.bcr
Main Authors: Yokoyama, Waka, Takada, Kazuki, Miyasaka, Nobuyuki, Kohsaka, Hitoshi
Format: Article
Language:English
Subjects:
Antibodies
Arthritis, Rheumatoid - drug therapy
Autoimmune diseases
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug dosages
Etanercept
Female
Humans
Immunoglobulin G - administration & dosage
Immunoglobulin G - adverse effects
Immunologic Factors - administration & dosage
Immunologic Factors - adverse effects
Infectious diseases
Japan
Lupus
Magnetic Resonance Imaging
Middle Aged
Multiple sclerosis
Myelitis - chemically induced
Myelitis - diagnosis
Optic Neuritis - chemically induced
Optic Neuritis - diagnosis
Other Asian
Patients
Proteins
Receptors, Tumor Necrosis Factor - administration & dosage
Remission (Medicine)
Rheumatoid arthritis
Spinal cord
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Tumor necrosis factor-TNF
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
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Description
Summary:A 64-year-old woman presented with an acute onset of myelitis and optic neuritis after 47 months of etanercept use for rheumatoid arthritis. Etanercept was discontinued and pulse methylprednisolone therapy (1000 mg/day for 3 days) was started, followed by a quick and complete resolution. Demyelination associated with antitumor necrosis factor agents, reported to develop mostly from 1 week to 12 months after the initiation of the agents, could develop after a few years and thus warrants vigilant monitoring.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2014-205779