Published in:
01-05-2006 | Case Report
Lethal acute respiratory distress syndrome during anti-TNF-α therapy for rheumatoid arthritis
Published in: Clinical Rheumatology | Issue 3/2006
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Tumor necrosis factor alpha (TNF-α) blocking drugs improve therapy for rheumatic diseases, but the risk of additional immunosuppression and infection is unclear. We report on a patient with rheumatoid arthritis treated with etanercept for 2 years, in addition to methotrexate and prednyliden, who developed fulminant pneumococcal pneumonia with rapid progression to fatal acute respiratory distress syndrome (ARDS) and septic shock. In patients receiving anti-TNF-α therapy, especially in combination with corticosteroids, signs of pulmonary infection should be regarded as very serious, as fulminant pneumonia with ARDS and severe sepsis may develop within 24 h.