Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab
Abstract TNF alpha antagonist-induced lupus-like syndrome is a rare condition which predominantly affects women (4:1). The average age of onset is 46-51 years. It occurs after exposure to TNF alpha antagonist and disappears after discontinuation of such agents. The pathogenic mechanism for development of the TNF alpha antagonist-induced lupus-like syndrome is not fully defined. It is believed that the medication induces apoptosis, leading to an accumulation of nucleosomal antigens of apoptotic cells. This would cause autoantibodies to be produced by susceptible individuals. The most common cutaneous manifestations include maculopapular exanthem, malar rash, alopecia, photosensitivity and, more rarely, vasculitis. Extracutaneous manifestations include: fever, weight loss, arthritis or arthralgia, myositis and hematological abnormalities. Antinuclear antibody may be positive in 80% of cases and anti-histone antibody is considered a disease marker for TNF alpha antagonist-induced lupus-like syndrome. Treatment corresponds to drug discontinuation. We report a rare case of sub-acute cutaneous lupus erythematosus with leukocytoclastic vasculitis induced by adalimumab in a 42-year-old patient.
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Sociedade Brasileira de Dermatologia
2015
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oai:scielo:S0365-059620150007001212015-11-19Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumabAmarante,Carolina ForteAcedo,Livia Mendes SabiaRabay,Fátima Maria de OliveiraCampos,Benedito do Espírito SantoLira,Márcia Lanzoni de AlvarengaMandelbaum,Samuel Henrique Exposure to biological agents Tumor necrosis factor-alpha Vasculitis, leukocytoclastic, cutaneous Abstract TNF alpha antagonist-induced lupus-like syndrome is a rare condition which predominantly affects women (4:1). The average age of onset is 46-51 years. It occurs after exposure to TNF alpha antagonist and disappears after discontinuation of such agents. The pathogenic mechanism for development of the TNF alpha antagonist-induced lupus-like syndrome is not fully defined. It is believed that the medication induces apoptosis, leading to an accumulation of nucleosomal antigens of apoptotic cells. This would cause autoantibodies to be produced by susceptible individuals. The most common cutaneous manifestations include maculopapular exanthem, malar rash, alopecia, photosensitivity and, more rarely, vasculitis. Extracutaneous manifestations include: fever, weight loss, arthritis or arthralgia, myositis and hematological abnormalities. Antinuclear antibody may be positive in 80% of cases and anti-histone antibody is considered a disease marker for TNF alpha antagonist-induced lupus-like syndrome. Treatment corresponds to drug discontinuation. We report a rare case of sub-acute cutaneous lupus erythematosus with leukocytoclastic vasculitis induced by adalimumab in a 42-year-old patient.info:eu-repo/semantics/openAccessSociedade Brasileira de DermatologiaAnais Brasileiros de Dermatologia v.90 n.3 suppl.1 20152015-06-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962015000700121en10.1590/abd1806-4841.20153834 |
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Amarante,Carolina Forte Acedo,Livia Mendes Sabia Rabay,Fátima Maria de Oliveira Campos,Benedito do Espírito Santo Lira,Márcia Lanzoni de Alvarenga Mandelbaum,Samuel Henrique |
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Amarante,Carolina Forte Acedo,Livia Mendes Sabia Rabay,Fátima Maria de Oliveira Campos,Benedito do Espírito Santo Lira,Márcia Lanzoni de Alvarenga Mandelbaum,Samuel Henrique Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
author_facet |
Amarante,Carolina Forte Acedo,Livia Mendes Sabia Rabay,Fátima Maria de Oliveira Campos,Benedito do Espírito Santo Lira,Márcia Lanzoni de Alvarenga Mandelbaum,Samuel Henrique |
author_sort |
Amarante,Carolina Forte |
title |
Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
title_short |
Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
title_full |
Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
title_fullStr |
Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
title_full_unstemmed |
Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
title_sort |
drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab |
description |
Abstract TNF alpha antagonist-induced lupus-like syndrome is a rare condition which predominantly affects women (4:1). The average age of onset is 46-51 years. It occurs after exposure to TNF alpha antagonist and disappears after discontinuation of such agents. The pathogenic mechanism for development of the TNF alpha antagonist-induced lupus-like syndrome is not fully defined. It is believed that the medication induces apoptosis, leading to an accumulation of nucleosomal antigens of apoptotic cells. This would cause autoantibodies to be produced by susceptible individuals. The most common cutaneous manifestations include maculopapular exanthem, malar rash, alopecia, photosensitivity and, more rarely, vasculitis. Extracutaneous manifestations include: fever, weight loss, arthritis or arthralgia, myositis and hematological abnormalities. Antinuclear antibody may be positive in 80% of cases and anti-histone antibody is considered a disease marker for TNF alpha antagonist-induced lupus-like syndrome. Treatment corresponds to drug discontinuation. We report a rare case of sub-acute cutaneous lupus erythematosus with leukocytoclastic vasculitis induced by adalimumab in a 42-year-old patient. |
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Sociedade Brasileira de Dermatologia |
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2015 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962015000700121 |
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