Case Report

Development of Crohn's Disease in a Patient Taking Etanercept

JENNY OH, DANIEL G. ARKFELD, and DAVID A. HORWITZ

ABSTRACT.

In addition to its well known proinflammatory effects, tumor necrosis factor-alpha (TNF-a) has complex effects on the growth, differentiation, and death of immune cells. TNF antagonists have had dramatic effects on the suppression of rheumatoid arthritis and other rheumatic inflammatory diseases. However, TNF inhibition of RA has led to an increased incidence of drug induced anti-dsDNA production, with cases of systemic lupus erythematosus as well as exacerbations of multiple sclerosis. While etanercept does not generally alter the course of Crohn's disease we describe a rare instance where this agent may have contributed to the development of clinically significant inflammatory bowel disease. (J Rheumatol 2005;32:752-3)

Key Indexing Terms:

CROHN'S DISEASE
AUTOIMMUNE DISEASE
ANTIINFLAMMATORY
TUMOR NECROSIS FACTOR

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From the Division of Rheumatology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

J. Oh, MD, Rheumatology Fellow; D.G. Arkfeld, MD, Assistant Professor of Medicine; D.A. Horwitz, MD, Professor of Medicine and Molecular Microbiology and Immunology, Chief, Division of Rheumatology.

Address reprint requests to Dr. D.G. Arkfeld, Division of Rheumatology, Keck School of Medicine, University of Southern California, 2011 Zonal Avenue, HMR 711, Los Angeles, CA 90032. E-mail: arkfeld@usc.edu

Accepted for publication November 19, 2004.

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