TABLE 1.
Patient No. | Age (y)/sex | Conditionb | Anti–TNF-α agent | Duration of treatment (mo)c | Korean algorithm scored | Organ involvement | Cutaneous lesions | Type of vasculitis | Use of anti–TNF-α agent discontinued | Time to resolution (mo)e | Treatment | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 54/F | Rheumatoid arthritis | Etanercept | 12 | 9 | Cutaneous | Ulcerated lesions, erythematous macules, blisters | CSVV | Yes | 1 | Prednisone | Complete response |
2 | 70/M | Rheumatoid arthritis | Infliximab | 72 | 9 | Cutaneous | Palpable purpura | CSVV | Yes | 2 | Prednisone, rituximab | Complete response |
3 | 43/F | Rheumatoid arthritis | Etanercept | 36 | 9 | Peripheral nerve | None | Neuropathy | Yes | 24 | Prednisone, cyclophosphamide | Partial response |
4 | 18/F | Crohn disease | Adalimumab | 60 | 9 | Cutaneous, peripheral nerve | Palpable purpura | CSVV, neuropathy | Yes | 2 | Prednisone, methotrexate | Complete response |
5 | 64/F | Rheumatoid arthritis | Infliximab | 60 | 9 | Cutaneous | Palpable purpura, ulcerated lesions | CSVV | Yes | 1 | Prednisone, hydroxychloroquine | Partial response |
6 | 52/M | Ulcerative colitis | Infliximab | 24 | 9 | Peripheral nerve | None | Neuropathy | Yes | 6 | Prednisone, azathioprine | Complete response |
7 | 21/F | Ulcerative colitis | Infliximab | 6 | 6 | Cutaneous, kidney | Palpable purpura | HSP | Yes | NAf | Prednisone, mycophenolate mofetil | No response |
8 | 66/F | Ulcerative colitis | Infliximab | 2 | 9 | Peripheral nerve | None | Neuropathy | Yes | 12 | Prednisone, mycophenolate mofetil | Partial response |
CSVV = cutaneous small-vessel vasculitis; HSP = Henoch-Schönlein purpura; NA = not applicable; TNF-α, = tumor necrosis factor-α.
The underlying condition was quiescent at the time vasculitis developed.
Before development of vasculitis.
Adverse drug reaction scores are as follows: 9 or higher for “certain,” 6 to 8 for “probable/likely,” 3 to 5 for “possible,” 1 to 2 for “unlikely,” and less than 0 for “contradictory.”12
After discontinued use of the anti–TNF-α agent.
Skin lesions persisted.