Background. Infliximab (Remicade.) is an anti- TNF alpha indicated in the treatment of chronic inflammatory rheumatism, notably rheumatoid arthritis. Case- report. We report the case of a 56 year- old woman who develo...Background. Infliximab (Remicade.) is an anti- TNF alpha indicated in the treatment of chronic inflammatory rheumatism, notably rheumatoid arthritis. Case- report. We report the case of a 56 year- old woman who developed severe worsening of an SSA- positive subacute lupus erythematosus on initiation of treatment with infliximab for rheumatoid arthritis. Discussion. A review of the literature found 30 cases of drug- induced lupus and listed the autoimmune modifications induced by anti- TNF alpha. This first case of subacute lupus erythematosus, existing before the introduction of treatment and worsening during the latter, emphasizes the risk of developing a severe flare of an autoimmune disease during treatment with anti- TNF alpha. It raises the question of the relative contraindications of anti- TNF alpha in patients with lupus erythematosus.展开更多
We report the case of a 42- year- old man with pseudoxanthoma elasticum (PXE) and recurrent bilateral nephrolithiasis. Diagnosis of PXE was made by yellow papules on the neck and ophthalmologic angioid streaks. This d...We report the case of a 42- year- old man with pseudoxanthoma elasticum (PXE) and recurrent bilateral nephrolithiasis. Diagnosis of PXE was made by yellow papules on the neck and ophthalmologic angioid streaks. This diagnosis was confirmed byaskinbiopsy(Von Kossa stain)and by genotyping analysis of ABCC6 (homozygous mutation R1138Q). Nephrolithiasis was recurrent and biological investigations showed hypophosphoraemia, hyperphosphaturia, hypercalciuria, normocalcaemia, normal serum parathyroid hormone value, high 1,25- dihydroxy vitamin D value and a renal calcium oxalate stone. ABCC6 encodes for MRP6, a multidrug resistant protein strongly expressed in the liver and kidney. The substrates of the MRP6 remain unknown. As PXE is characterized by calcification of elastic fibres and this patient presents important phosphocalcic anomalies, we discuss the possible implications of MRP6 in the phosphocalcic metabolism.展开更多
文摘Background. Infliximab (Remicade.) is an anti- TNF alpha indicated in the treatment of chronic inflammatory rheumatism, notably rheumatoid arthritis. Case- report. We report the case of a 56 year- old woman who developed severe worsening of an SSA- positive subacute lupus erythematosus on initiation of treatment with infliximab for rheumatoid arthritis. Discussion. A review of the literature found 30 cases of drug- induced lupus and listed the autoimmune modifications induced by anti- TNF alpha. This first case of subacute lupus erythematosus, existing before the introduction of treatment and worsening during the latter, emphasizes the risk of developing a severe flare of an autoimmune disease during treatment with anti- TNF alpha. It raises the question of the relative contraindications of anti- TNF alpha in patients with lupus erythematosus.
文摘We report the case of a 42- year- old man with pseudoxanthoma elasticum (PXE) and recurrent bilateral nephrolithiasis. Diagnosis of PXE was made by yellow papules on the neck and ophthalmologic angioid streaks. This diagnosis was confirmed byaskinbiopsy(Von Kossa stain)and by genotyping analysis of ABCC6 (homozygous mutation R1138Q). Nephrolithiasis was recurrent and biological investigations showed hypophosphoraemia, hyperphosphaturia, hypercalciuria, normocalcaemia, normal serum parathyroid hormone value, high 1,25- dihydroxy vitamin D value and a renal calcium oxalate stone. ABCC6 encodes for MRP6, a multidrug resistant protein strongly expressed in the liver and kidney. The substrates of the MRP6 remain unknown. As PXE is characterized by calcification of elastic fibres and this patient presents important phosphocalcic anomalies, we discuss the possible implications of MRP6 in the phosphocalcic metabolism.
