Case Report
Etanercept as a Possible Trigger of Fatal Pulmonary Fibrosis
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Díez Piña, Óscar Vázquez Gómez, Sagrario Mayoralas Alises, José D. García Jiménez, Dolores Álvaro Álvarez, M. Paz Rodríguez Bolado" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Juan M." "apellidos" => "Díez Piña" "email" => array:1 [ 0 => "jmdpas@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Óscar Vázquez" "apellidos" => "Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Sagrario Mayoralas" "apellidos" => "Alises" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "José D." "apellidos" => "García Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Dolores Álvaro" "apellidos" => "Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "M. Paz Rodríguez" "apellidos" => "Bolado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de Móstoles, Móstoles, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital de Mostoles, Móstoles, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr J.M. Díez Piña C/Palo de Rosa, 3, escalera 3,7 A 28005 Madrid, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-03-05" "fechaAceptado" => "2008-01-30" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155324" "palabras" => array:3 [ 0 => "Etanercept" 1 => "Pulmonary fibrosis" 2 => "Tumor necrosis factor" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Pulmonary fibrosis can be caused by external agents, including certain drugs. For some time now, tumor necrosis factor antagonists such as etanercept have been used to treat certain autoimmune diseases. Fibrosis caused by medication responds to withdrawal of the drug and treatment with corticosteroids. Very rarely, fibrosis is irreversible. We present the case of a patient who developed pulmonary fibrosis after initiating treatment with etanercept. The clinical course was fulminant despite withdrawal of the drug and high doses of corticosteroids.</p><p class="elsevierStyleSimplePara elsevierViewall">La fibrosis pulmonar es una enfermedad que puede estar causada por agentes externos como determinados fármacos. Desde hace un tiempo se utilizan fármacos antagonistas del factor de necrosis tumoral (TNF) para ciertas enfermedades autoinmunitarias, siendo un ejemplo de estos fármacos el etanercept. Las fibrosis secundarias a medicamentos se caracterizan por la respuesta a la retirada del fármaco y a esteroides. En muy raras ocasiones se produce una fibrosis irreversible. Presentamos el caso de un paciente que desarrollo una fibrosis pulmonar tras iniciar tratamiento con etanercept y que tuvo un curso clinico nefasto a pesar de la retirada del anti-TNF y dosis altas de esteroides.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differences between anti-TNF-alpha monoclonal antibodies and soluble TNF receptors in host defense impairment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "CA Dinarello" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Rheumatol" "fecha" => "2005" "volumen" => "32" "paginaInicial" => "40" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15630722" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treating psoriatic arthritis: how effective are TNF antagonists?" 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