North Texas Research Forum 2024



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North Texas


Medical City Fort Worth



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Etanercept, vasculitis


Cardiovascular Diseases | Dermatology | Medicine and Health Sciences


Introduction: IgA vasculitis, formerly known as Henoch-Schoenlein purpura, is a subtype of leukocytoclastic vasculitis (LCV) and approximately 90% are seen in the pediatric population. In the adult population, it is more frequently associated with a more severe clinical course. Causes of IgA vasculitis may be idiopathic or may be secondary to infections or medications. Etanercept is a tumor necrosis factor-alpha fusion protein that has been rarely associated with LCV. Case presentation: A 59-year-old female with a 2-year history of red-to-violaceous purpuric papules on the bilateral lower extremities. She noted that after etanercept administration her lesions would get redder and would become more numerous. She was diagnosed with rheumatoid arthritis over 20 years ago. She had been treated with methotrexate and etanercept for approximately 5 years. A biopsy of the lesion showed LCV. Direct immunofluorescence showed granular deposition of IgA and C3 within small vessels, consistent with IgA vasculitis. Serum BUN, creatinine, and urine analysis were normal. Learning points: IgA vasculitis is a serious illness that may be associated with systemic organ involvement. It can lead to renal insufficiency and require dialysis. Identifying an underlying etiology may allow treatment that resolves this condition. We identified a patient whose disease was exacerbated by etanercept therapy and is 80% better after stopping etanercept. She had full resolution of any lesions with colchicine within 2 weeks of starting therapy. As biologic therapies become increasingly prevalent, associated adverse events are expected to similarly become more frequent. Recognizing such adverse events is important to prevent the progression of the disease and its associated comorbidities.

Original Publisher

HCA Healthcare Graduate Medical Education

Etanercept-induced IgA Vasculitis



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