Revista de vasculitis

Central Nervous System Vasculitis Complicating Rheumatoid Arthritis in a Patient on a TNF Inhibitor: a Causal Association? Case Report and Systematic Review

Abstract

Adam Joseph Brown*, Susan M Staugaitis, Alex Wu, Leonard H. Calabrese

Primary Angiitis of the Central Nervous System (PACNS) is a rare disease that causes inflammation and destruction of the vessels within the CNS without evidence of a systemic vasculitic process. There is little known about the etiology of this disease entity but there are a limited number of case reports of CNS vasculitis being associated with biologic therapies in particular TNF antagonists. TNF antagonists have been in use for over 20 years for the treatment of numerous immunologic diseases. It is estimated that over 3 million people have been exposed to these drugs. TNF antagonists have rarely been associated with the development of vasculitis. Here we present a case of a biopsy proven CNS vascultis developing in a patient with rheumatoid arthritis while taking etanercept with a systematic review of the literature regarding TNF antagonists and subsequent development of CNS vasculitis.