Lupus myositis with normal creatinine kinase levels following adalimumab use in a rheumatoid arthritis patient / bir romatoid artrit hastaslnda adalimumab kullanlmlnln ardlndan gelisen ve normal kreatinin kinaz seviyelerinin eslik ettigi lupus miyoziti

• Published in: Turkish journal of rheumatology Vol. 26; no. 4; p. 328
• Main Authors: Almoallim, Hani, ALmasari, Ahlam, Khadawardi, Hadeel
• Format: Journal Article
• Language: English
• Published: Turkish League Against Rheumatism 01.12.2011
• Subjects: Antibodies; Antirheumatic agents; Arthritis; Autoantibodies; DNA; Myositis; Rheumatoid arthritis; Rheumatoid factor; Systemic lupus erythematosus; Tumor necrosis factor; Viral antibodies
• ISSN: 1309-0291; 1309-0283
• DOI: 10.5606/tjr.2011.053

We report a rare case of histopathologically confirmed lupus myositis that developed in a 32-year-old female with seropositive rheumatoid arthritis that had been treated with adalimumab for one year. She had demonstrated excellent response to her arthritis initially but then developed profound muscle weakness with a conversion of her antinuclear antibody and anti-double stranded DNA from negative to strongly positive. Her creatinine kinase levels remained normal. She responded well to high-dose steroid therapy and rituximab. Key words: Adalimumab; anti-TNF therapy; drug-induced lupus erythematosus; lupus myositis. Bu yazida bir yil boyunca adalimumabla tedavi edilen seropozitif romatoid artritli 32 yasindaki bir kadin hastada gelisen histolojik olarak dogrulanmis nadir bir lupus miyoziti olgusu bildirildi. Hastanin artriti baslangicta mukemmel bir yanit verdi, ancak hastada daha sonra, antinukleer antikor ve anti-cift sarmalli DNA'da negatiften guclu sekilde pozitife donusumle birlikte onemli duzeyde kas gucsuzlugu gelisti. Hastanin kreatinin kinaz duzeyi ise normal kaldi. Hasta yuksek dozlu steroid tedavisine ve rituksimaba iyi yanit verdi. Anahtar sozcukler: Adalimumab; anti-TNF tedavi; ilac kaynakli lupus eritematosus; lupus miyoziti.