Adalimumab-Induced Rhupus Syndrome in a Female Patient Affected with Anti-Citrullinated Protein Antibody (ACPA)-Positive Rheumatoid Arthritis (RA): A Case Report and Review of Literature
Open Access
- 1 July 2021
- journal article
- case report
- Published by MDPI AG in Clinics and Practice
- Vol. 11 (3), 404-409
- https://doi.org/10.3390/clinpract11030055
Abstract
We report a 38-year-old female patient affected with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) who developed mild hemolytic anemia (Hb = 10.5 vs. >12 gr/dL), indolent oral ulceration, ANA (1:1280, homogeneous pattern), and anti-dsDNA antibody positivity following 8 months of therapy with an adalimumab biosimilar (GP2017). Rhupus syndrome was diagnosed. Replacing GP2017 with infliximab, anemia, oral ulcer, and anti-dsDNA antibodies quickly disappeared, while low-titers (1:80) ANA are still present after more than a year. The possibility that the patient suffered from rhupus rather than drug-induced lupus erythematosus associated to anti-ACPA positivity RA was discussed. To date, after a 14-month follow-up, no manifestations of LE have reappeared. To the best of our knowledge, this is the first report of adalimumab-induced rhupus.Keywords
This publication has 30 references indexed in Scilit:
- Study of the common genetic background for rheumatoid arthritis and systemic lupus erythematosusAnnals Of The Rheumatic Diseases, 2010
- The Disease Activity Score and the EULAR Response CriteriaRheumatic Disease Clinics of North America, 2009
- Adalimumab safety and mortality rates from global clinical trials of six immune-mediated inflammatory diseasesAnnals Of The Rheumatic Diseases, 2009
- Adalimumab-induced lupus erythematosusLupus, 2008
- Drug‐Induced LupusAnnals of the New York Academy of Sciences, 2007
- Safety analyses of adalimumab (HUMIRA) in global clinical trials and US postmarketing surveillance of patients with rheumatoid arthritisAnnals Of The Rheumatic Diseases, 2005
- AdalimumabBioDrugs, 2004
- Coexistent rheumatoid arthritis and systemic lupus erythematosus: clinical, serological, and phenotypic features.Annals Of The Rheumatic Diseases, 1992
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988
- Autoimmune haemolysis: an 18-year study of 865 cases referred to a regional transfusion centre.BMJ, 1981