Year: 2025
Type: article
Study design: Case Report
Abstract: Tumor necrosis factor (TNF) inhibitors have significantly improved outcomes for patients with rheumatoid arthritis (RA). However, these biologic agents can lead to rare but serious adverse events, including drug-induced vasculitis. We report a rare case of anti-TNF-induced medium-vessel vasculitis in a 33-year-old female with seronegative RA and a complex medical history. After inadequate responses and adverse effects from previous treatment, the patient was switched to anti-TNF certolizumab pegol. Shortly after initiation, she developed painful, erythematous, and pruritic rashes on her hands and arms. A skin biopsy confirmed medium-vessel vasculitis. The condition improved following the discontinuation of certolizumab and initiation of immunosuppressive therapy with corticosteroids. This case underscores the importance of vigilance for dermatologic adverse effects in patients receiving TNF inhibitors. Vasculitis should be considered as a differential diagnosis when new skin lesions appear during biologic therapy, and management should be initiated accordingly.
Source: Cureus
DOI: 10.7759/cureus.93342
Authors: Mehrnoush Hassas Yeganeh, Arooba Malik, Aya Yaseen, Hamidreza Zefreh, Daniel Shostak, Sajina Prabhakaran
Institutions: Capital Health, Isfahan University of Medical Sciences
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414569805