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Fatal acute necrotizing eosinophilic myocarditis temporally related to use of adalimumab in a patient with relapsing polychondritis.

Abstract
Tumor necrosis factor α (TNF-α) antagonists are being increasingly used as maintenance therapies for rheumatic diseases, and therefore knowledge of their adverse effects is important. We report a case of fatal acute necrotizing eosinophilic myocarditis temporally related to use of a second course of the TNF-α antagonist, adalimumab. A 51-year-old woman with relapsing polychondritis took adalimumab 2 weeks before presenting with acute myocarditis. Within hours of presentation to the emergency department, she had cardiac arrest due to fulminant heart failure. Autopsy demonstrated necrotizing eosinophilic myocarditis. This is a rare cause of fulminant heart failure. This is the first report of a TNF-α antagonist potentially associated with acute necrotizing eosinophilic myocarditis.
AuthorsRosemary Adamson, Yusuf Yazici, Edward S Katz, Stewart G Greisman, David Steiger
JournalJournal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 19 Issue 7 Pg. 386-9 (Oct 2013) ISSN: 1536-7355 [Electronic] United States
PMID24048108 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Tumor Necrosis Factor-alpha
  • Adalimumab
Topics
  • Acute Disease
  • Adalimumab
  • Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
  • Antirheumatic Agents (adverse effects, therapeutic use)
  • Autopsy
  • Comorbidity
  • Eosinophilia (chemically induced, epidemiology, pathology)
  • Fatal Outcome
  • Female
  • Humans
  • Middle Aged
  • Myocarditis (chemically induced, epidemiology, pathology)
  • Myocardium (pathology)
  • Polychondritis, Relapsing (drug therapy)
  • Tumor Necrosis Factor-alpha (antagonists & inhibitors)

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