Subacute thyroiditis presenting as fever of unknown origin in a patient with rheumatoid arthritis under etanercept treatment.

摘要

In September 2007, a 50-year-old woman presented with unexplained fever of 2 weeks duration. The patient had erosive rheumatoid arthritis for 8 years, which was initially resistant to treatment with corticosteroids, hydroxychloroquine, and methotrexate. For the past 4 years, she was being treated successfully with a combination of an anti-tumor necrosis factor (TNF) agent (etanercept, 50 mg/ wk), low dose prednisolone (5 mg/d), and hydroxychloroquine. One year after treatment initiation with etanercept, she developed discoid lupus (facial skin rash, positive antinuclear antibodies, positive skin biopsy), without evidence of systemic involvement that was treated successfully with local corticosteroids, without discontinuing etanercept.