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Báo cáo y học: " Etanercept and venous thromboembolism: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Etanercept and venous thromboembolism: a case series | Makol et al. Journal of Medical Case Reports 2010 4 12 http www.jmedicalcasereports.eom content 4 1 12 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Etanercept and venous thromboembolism a case series Ashima Makol1 Madhusudan Grover1 Carla Guggenheim2 Houria Hassouna3 Abstract Introduction The treatment with antitumor necrosis factor agents has often been associated with the induction of autoantibodies antinuclear antibodies anti-double stranded DNA antibodies and antiphospholipid antibodies . The clinical significance of these antibodies remains unclear but they may predispose to antiphospholipid syndrome with thromboembolic complications. The association of etanercept with thromboembolic events has not been reported previously in the literature. Case presentation We describe the cases of three patients with rheumatoid arthritis psoriatic arthritis and seronegative inflammatory arthritis who were treated with etanercept. They developed deep vein thrombosis and or pulmonary embolism one to three years after the initiation of etanercept therapy. All three patients had a prolonged activated partial thromboplastin time with a positive lupus anticoagulant that persisted even after 12 weeks. Conclusion Although the clinical significance of antiphospholipid antibodies during treatment with antitumor necrosis factor agents remains unclear they may predispose patients to develop antiphospholipid syndrome when associated with prolonged activated partial thromboplastin time lupus anticoagulant positivity or the presence of anti-p2 glycoprotein I. Clinicians must keep this in mind during therapy with antitumor necrosis factor agents in order to prevent detect and treat potential consequences such as deep vein thrombosis and pulmonary embolism. Introduction Etanercept Enbrel Immunex Thousand Oaks California is a dimeric recombinant DNA protein composed of two naturally occurring soluble human tumor necrosis factor TNF receptors linked to the Fc portion of .