TY -的T1 Etanercept-induced pleuropericardial lupus-like syndrome JF - European Respiratory Journal JO - Eur Respir J SP - 939 LP - 941 DO - 10.1183/09031936.00182308 VL - 33 IS - 4 AU - Porfyridis, I. AU - Kalomenidis, I. AU - Psallidas, I. AU - Stratakos, G. AU - Roussos, C. AU - Vassilakopoulos, T. AU - Stathopoulos, G. T. Y1 - 2009/04/01 UR - //www.qdcxjkg.com/content/33/4/939.abstract N2 - To the Editors: Tumour necrosis factor (TNF)-α is currently being targeted in autoimmune joint diseases, including rheumatoid arthritis (RA) and spondylarthropathies 1, 2. Widespread use of anti-TNF-α therapies (e.g. etanercept) has unveiled a spectrum of adverse effects, including infection 3 and a systemic lupus erythematosus (SLE)-like syndrome 4. The latter appears to be biologically based on perturbations in TNF-α-controlled homeostasis of interferon (IFN)-α 5, and is betrayed by seroconversion of SLE markers 6. With interest, we read the occurrence of pleural effusions associated with anti-TNF-α agents 7. We encountered a patient with RA taking etanercept, who developed alternating pleural effusions. We obtained measurements that suggested that a lupus-like syndrome and not a common drug reaction precipitated these pleural effusions. A 50-yr-old Greek ex-smoker presented with acute-onset fever (39°C), malaise and right-sided pleuritic pain. She had long-standing seropositive RA and was started on 25 mg bi-weekly subcutaneous etanercept 3 yrs earlier (when tuberculin skin test was 0 mm and chest radiograph negative). Her prior serology was: negative antinuclear antibody (ANA) and anti-double stranded (ds)DNA antibody and a rheumatoid factor (RF) of 35 U·L … ER -