Document Detail

A case of cervical spine meningioma following etanercept use in a patient with RA.
MedLine Citation:
PMID:  19648944     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A 70-year-old female with active rheumatoid arthritis (RA) was administered etanercept to treat active disease that persisted despite therapy with conventional DMARDs. After 18 months of etanercept therapy, her RA symptoms had improved; however, she developed quadriparesis. She presented to a specialist rheumatology clinic with weakness and numbness in her arms and legs; she also had difficulty in standing up and walking. INVESTIGATIONS: Physical examination, neurological examination, nerve conduction studies, measurement of serum inflammatory markers and autoantibodies, MRI of the cranium and cervical spine, and X-rays of the chest and hands. DIAGNOSIS: The patient underwent neurosurgery to resect a 1 x 2 cm mass in the cervical spine at C6-C7. Histopathologic examination of the excised mass revealed it to be a meningioma. MANAGEMENT: Etanercept was discontinued because of a possible association between the drug and development of meningioma; however, shortly afterwards the patient experienced a flare of RA symptoms. High-dose NSAIDs and prednisolone were administered, but the patient died because of gastric perforation. To our knowledge, this is the first report in the literature of meningioma developing following use of tumor necrosis factor inhibitor therapy, and the first to suggest a cause-effect relationship.
Omer N Pamuk; Ferda Harmandar
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nature reviews. Rheumatology     Volume:  5     ISSN:  1759-4804     ISO Abbreviation:  Nat Rev Rheumatol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101500080     Medline TA:  Nat Rev Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-60     Citation Subset:  IM    
Division of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey.
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MeSH Terms
Antirheumatic Agents / adverse effects*
Arthritis, Rheumatoid / drug therapy*
Cervical Vertebrae
Fatal Outcome
Immunoglobulin G / adverse effects*
Meningioma / chemically induced*
Receptors, Tumor Necrosis Factor
Spinal Cord Neoplasms / chemically induced*
Reg. No./Substance:
0/Antirheumatic Agents; 0/Immunoglobulin G; 0/Receptors, Tumor Necrosis Factor; 185243-69-0/TNFR-Fc fusion protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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