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Tumour necrosis factor α (TNFα) antagonists have been shown to be effective in controlling symptoms in patients with rheumatoid arthritis (RA)1,2 and juvenile RA (JRA).1 The most common adverse events associated with etanercept are injection site reactions and infections, and with infliximab, headache, infections and, occasionally, infusion related reactions.2 Cutaneous vasculitis associated with etanercept has been described in three patients, and one of them also had a similar skin manifestation secondary to the treatment with infliximab.3 The possible association of a demyelinating syndrome with the use of anti-TNF agents in inflammatory arthritides needs further surveillance.4
CASE REPORT
A 31 year old female patient has had juvenile rheumatic disease since the age of 10. She has had a polyarticular disease in her peripheral joints with inflammatory manifestations both in the cervical spine and sacroiliac joints. She is HLA-B27 positive. At the time of diagnosis she was treated with aurothiomalate and hydroxychloroquine, but they were withdrawn because …