TY - JOUR T1 - Tumor Necrosis Factor-α Inhibitor-induced Antiglomerular Basement Membrane Antibody Disease in a Patient with Rheumatoid Arthritis JF - The Journal of Rheumatology JO - J Rheumatol SP - 1904 LP - 1905 DO - 10.3899/jrheum.120325 VL - 39 IS - 9 AU - KEISUKE NISHIMURA AU - JUN SAEGUSA AU - SEIJI KAWANO AU - AKIO MORINOBU Y1 - 2012/09/01 UR - http://www.jrheum.org/content/39/9/1904.abstract N2 - To the Editor:Tumor necrosis factor (TNF)–targeted therapy is widely used for various rheumatic diseases. However, severe adverse effects have been reported, with a number of studies reporting the development of vasculitis associated with anti-TNF agents1,2,3. This is the first report, to our knowledge, of a patient with rheumatoid arthritis (RA) who developed antiglomerular basement membrane (anti-GBM) antibody disease during treatment with adalimumab, a fully human immunoglobulin G1 monoclonal antibody against TNF-α.A 69-year-old woman was diagnosed with RA based on the criteria of the American College of Rheumatology/European League Against Rheumatism (2010) at the age of 68 years because she presented with symmetrical small-joint arthritis and was positive for anticitrullinated protein antibodies (ACPA)4. Treatment with methotrexate, bucillamine, and prednisolone was started, but was stopped 5 months later because interstitial lung disease was detected, after which adalimumab was initiated (40 mg biweekly). There were no findings of renal dysfunction, proteinuria/hematuria, or rheumatoid vasculitis before … Address correspondence to Dr. J. Saegusa, Department of Clinical Pathology and Immunology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. E-mail: jsaegusa{at}med.kobe-u.ac.jp ER -