Etanercept
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Demyelinating disease and cutaneous lymphocytic vasculitis: case report A 59-year-old woman developed demyelinating disease and cutaneous lymphocytic vasculitis while receiving etanercept for rheumatoid arthritis. The woman began receiving etanercept [dosage not stated] and, 24 hours after her third dose, developed a large annular and erythematous skin reaction over the injection sites on both thighs. She also had paraesthesias on the left side of her inferior lip and legs, an intense headache, a short episode of lateropulsion towards the left and intermittent diplopia. She was admitted to hospital. Etanercept was discontinued. Small nonspecific punctate hyperintense lesions in her periventricular and subcortical white matter were revealed by fluid attenuated inversionrecovery and T2-weighted MRI scans. A skin biopsy from her cutaneous lesion revealed lymphocytic vasculitis. The infiltrate consisted of mature CD3+ T-lymphocytes, with a predominance of CD4+ T-cells. After 5 days, her symptoms had partially resolved, and she was discharged. Two months later, an MRI scan revealed slight progression of her periventricular lesions and, in her subcortical white matter, three new small punctate lesions. The lesions were thought to be unspecific demyelinating lesions. For 7 months after she was discharged, she continued to have paraesthesias on the distal areas of both legs. Mart´ınez-Taboada VM, et al. Demyelinating disease and cutaneous lymphocitic vasculitis after etanercept therapy in a patient with rheumatoid arthritis. Scandinavian Journal of Rheumatology 35: 322-323, No. 4, Jul 2006 801050012 Spain
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Reactions 11 Nov 2006 No. 1127
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