TY - JOUR T1 - Hypersensitive Joint Reaction After Etanercept Treatment in a Patient with Juvenile Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 577 LP - 579 DO - 10.3899/jrheum.100751 VL - 38 IS - 3 AU - MINDY MING-HUEY GUO AU - KUENDER D. YANG AU - HONG-REN YU AU - HO-CHANG KUO Y1 - 2011/03/01 UR - http://www.jrheum.org/content/38/3/577.abstract N2 - To the Editor:Etanercept is a soluble tumor necrosis factor (TNF) antagonist used worldwide for autoimmune diseases, including rheumatoid arthritis (RA), juvenile RA (JRA)1, psoriatic arthritis, and ankylosing spondylitis2. The optimal dose of etanercept that is both effective and safe may depend on individual patient factors, and it remains a topic that would benefit from further studies. We report the first case of hypersensitive joint reaction in a patient with JRA under etanercept treatment.A 19-year-old woman was diagnosed with polyarticular JRA at the age of 15 years. Presentation at the time of diagnosis included swelling and arthralgia in the knees, ankles, and elbows for more than 6 weeks. She also complained of a painful sensation in both hip joints and morning stiffness in her hands during that period. The laboratory data showed antinuclear antibody (ANA) of 1:40 (speckled), rheumatoid factor 28.8 IU/ml (normal < 15 IU/ml), and C3/C4 levels 150/35 mg/dl at diagnosis. Because of a poor response to disease-modifying antirheumatic drugs (DMARD), including methotrexate (10 mg/m2/week) and prednisolone (0.25 mg/day/kg), which were administered for more than 3 months, she took etanercept at a dose of 25 mg (0.6 mg/kg/week) subcutaneously once a week. However, she complained of swelling in multiple joints, which was most notable over the right knees and ankles and lasted for 2–3 days after each etanercept injection. Because of the adverse joint reaction … Address correspondence to Dr. H-C. Kuo, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123 Ta-Pei Road, Niaosung Hsiang, Kaohsiung, Taiwan. E-mail: erickuo48{at}yahoo.com.tw. ER -