https://doi.org/10.4081/reumatismo.2024.1658

Systemic lupus erythematosus induced by anti-tumor necrosis factor α therapy in inflammatory rheumatic diseases: a case series

Early Access
Submitted: 10 October 2023
Accepted: 3 May 2024
Published: 24 September 2024
Systemic lupus erythematosus, anti-tumour necrosis factor alpha therapy, rheumatoid arthritis, spondylarthritis, psoriatic arthritis
Abstract Views: 37
PDF: 28
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Authors

D. Oliveira
danielasoff@gmail.com
https://orcid.org/0000-0001-9734-3162
Rheumatology Department, Centro Hospitalar Universitário São João, Porto; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Portugal.
A. Martins
https://orcid.org/0000-0001-7581-4074
Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal.
F. Martins
Rheumatology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
C. Gomes
https://orcid.org/0000-0003-4099-5973
Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal.
S. Pimenta
Rheumatology Department, Centro Hospitalar Universitário São João, Porto; Medicine Department, Faculty of Medicine, University of Porto, Portugal.
C. Vaz
Rheumatology Department, Centro Hospitalar Universitário São João, Porto; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto; Medicine Department, Faculty of Medicine, University of Porto, Portugal.
L. Costa
Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal.
M. Bernardes
https://orcid.org/0000-0002-1849-5465
Rheumatology Department, Centro Hospitalar Universitário São João, Porto; Medicine Department, Faculty of Medicine, University of Porto, Portugal.

This case series aims to characterize the development of systemic lupus erythematosus (SLE) induced by anti-tumor necrosis factor α (anti-TNFα) therapy in patients with inflammatory rheumatic diseases, namely rheumatoid arthritis (RA), spondylarthritis (SpA), and psoriatic arthritis (PsA). Patients with a diagnosis of SLE induced by anti-TNFα therapy and registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) who started their first anti-TNFα between 2001 and 2020 were included. Demographic, clinical, and laboratory data were obtained by consulting Reuma.pt. The diagnosis of SLE induced by anti-TNFα was considered if there was a temporal relationship between the onset of anti-TNFα therapy and manifestations (clinical and immunological) in accordance with the American College of Rheumatology/European League Against Rheumatism criteria (2019). A total of 607 patients with inflammatory rheumatic diseases and six cases of SLE induced by anti-TNF-α therapy were reviewed: two patients were affected by RA, three patients by SpA, and one by PsA. All these patients had articular and constitutional symptoms that improved after discontinuation of the anti-TNFα agent. After switching to a second anti-TNFα agent, there was no recurrence of SLE over time. The development of SLE secondary to anti-TNFα agents in inflammatory rheumatic patients is rare. In this case series, all patients had a mild disease that improved after therapy discontinuation without recurrence of the disease. SLE induced by anti-TNFα should be considered in the follow-up of RA, SpA, and PsA patients.

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How to Cite

Oliveira, D., Martins, A., Martins, F., Gomes, C., Pimenta, S., Vaz, C., … Bernardes, M. (2024). Systemic lupus erythematosus induced by anti-tumor necrosis factor α therapy in inflammatory rheumatic diseases: a case series. Reumatismo. https://doi.org/10.4081/reumatismo.2024.1658
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