Hodgkin’s Lymphoma Associated with Anti-Tumor Necrosis Factor Use in Juvenile Idiopathic Arthritis: Supplemental Case Report

Excerpt

To the Editor:

We describe an additional patient with juvenile idiopathic arthritis (JIA) who developed a malignancy to augment the case series in the current issue of The Journal¹. Our patient was diagnosed with polyarticular JIA at the age of 14 years (rheumatoid factor, antinuclear antibodies, and HLA-B27 negative). She was treated with nonsteroidal antiinflammatory drugs and methotrexate (MTX), eventually at a dose of 25 mg/week, given subcutaneously. Her arthritis improved, but radiographs showed new erosions at the metacarpophalangeal joints; she had difficulty tolerating MTX because of nausea, and at 17 years 3 months of age, etanercept was started at…