Abstract

Anti-tumor necrosis factor alpha (anti-TNFα) agents are used to treat inflammatory diseases with recognized safety and efficacy. Although they are rare, severe hematologic adverse effects are described and may be fatal. The current study describes the case of a patient presenting psoriatic arthritis, and under prolonged treatment with adalimumab. His condition worsened due to severe acute thrombocytopenia and severe hemorrhagic manifestations. Adalimumab was considered to be the probable cause of the thrombocytopenia and, therefore, its use was discontinued. The treatment consisted of corticosteroids, human immunoglobulin, rituximab and transfusion support. The regular monitoring of cytopenias in patients using anti-TNFα agents may be a safe measure for the early detection of severe hematologic adverse events. It is worth conducting additional studies to better characterize the interaction between anti-TNFα agents and the hematopoietic and immune systems.

Authors and Affiliations