Tumor Necrosis Factor Inhibitor-Associated Dermatomyositis
Tumor Necrosis Factor Inhibitor-Associated Dermatomyositis
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DOI：
10.1001/archdermatol.2010.142
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发表时间：
2010-07-01
影响因子：
--
通讯作者：
Dunham, Jonathan
中科院分区：
文献类型：
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作者：
Klein, Rachel;Rosenbach, Misha;Dunham, Jonathan
背景：皮肌炎是一种病因不明的自身免疫性疾病，以皮肤和肌肉炎症为特征。几种药物与皮肌炎的发展有关;然而，这种疾病很少与肿瘤坏死因子（TNF）抑制剂的使用有关。我们报告4例皮肌炎的发展或暴露于TNF抑制剂依那西普和adalimumab.Observation恶化：4例炎症性关节炎的症状与TNF抑制剂治疗的持续时间范围从2个月到2年。所有4名患者均出现与皮肌炎一致的症状，包括炎性皮疹和肌无力。他们的症状持续后，停止治疗的TNF抑制剂，但皮质类固醇和免疫抑制medications.Conclusions治疗反应：肿瘤坏死因子抑制剂已与发病的一些自身免疫性疾病，最常见的血管炎和狼疮样综合征。它们很少与皮肌炎有关。本文报道的4例病例表明，TNF抑制剂的使用可能与皮肌炎的诱导或加重有关。
Background: Dermatomyositis is an autoimmune disease of unknown etiology characterized by inflammation of the skin and muscles. Several medications have been implicated in the development of dermatomyositis; however, the disease has rarely been linked to the use of tumor necrosis factor (TNF) inhibitors. We report 4 cases of dermatomyositis that developed or were exacerbated by exposure to the TNF inhibitors etanercept and adalimumab.Observation: Four patients with symptoms of inflammatory arthritis were treated with TNF inhibitors for a duration ranging from 2 months to 2 years. All 4 patients developed symptoms consistent with dermatomyositis, including inflammatory rash and muscle weakness. Their symptoms persisted after discontinuation of the treatment with the TNF inhibitors but responded to treatment with corticosteroids and immunosuppressive medications.Conclusions: Tumor necrosis factor inhibitors have been associated with the onset of a number of autoimmune disorders, most commonly vasculitis and a lupuslike syndrome. Rarely have they been associated with dermatomyositis. The 4 cases reported herein indicate that TNF inhibitor use can be associated with either induction or exacerbation of dermatomyositis.