我们报告了一名38岁女性患者,患有抗瓜氨酸蛋白抗体(ACPA)阳性类风湿关节炎(RA),患有轻度溶血性贫血(Hb=10.5vs.>12gr/dL),惰性口腔溃疡,ANA(1:1280,均匀模式),使用阿达木单抗生物仿制药(GP2017)治疗8个月后,抗dsDNA抗体阳性。诊断为Rhupus综合征。用英夫利昔单抗代替GP2017,贫血,口腔溃疡,抗dsDNA抗体很快就消失了,而低滴度(1:80)ANA在一年多后仍然存在。讨论了患者患有rhupus而不是与抗ACPA阳性RA相关的药物诱发的红斑狼疮的可能性。迄今为止,经过14个月的随访,LE的表现没有再次出现。据我们所知,这是阿达木单抗诱导的rhupus的首次报道.
We report a 38-year-old female patient affected with anti-citrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA) who developed mild hemolytic anemia (Hb = 10.5 vs. >12 gr/dL), indolent oral ulceration, ANA (1:1280, homogeneous pattern), and anti-dsDNA antibody positivity following 8 months of therapy with an adalimumab biosimilar (GP2017). Rhupus syndrome was diagnosed. Replacing GP2017 with infliximab, anemia, oral ulcer, and anti-dsDNA antibodies quickly disappeared, while low-titers (1:80) ANA are still present after more than a year. The possibility that the patient suffered from rhupus rather than drug-induced lupus erythematosus associated to anti-ACPA positivity RA was discussed. To date, after a 14-month follow-up, no manifestations of LE have reappeared. To the best of our knowledge, this is the first report of adalimumab-induced rhupus.