Fatal Acute Necrotizing Eosinophilic Myocarditis Temporally Related to Use of Adalimumab in a Patient With Relapsing Polychondritis.
Adamson, Rosemary MB, BS, BA *; Yazici, Yusuf MD +; Katz, Edward S. MD ++; Greisman, Stewart G. MD [S]; Steiger, David MD [//]
[Report] JCR: Journal of Clinical Rheumatology. 19(7):386-389, October 2013.

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Tumor necrosis factor [alpha] (TNF-[alpha]) antagonists are being increasingly used as maintenance therapies for rheumatic diseases, and therefore knowledge of their adverse effects is important. We report a case of fatal acute necrotizing eosinophilic myocarditis temporally related to use of a second course of the TNF-[alpha] antagonist, adalimumab. A 51-year-old woman with relapsing polychondritis took adalimumab 2 weeks before presenting with acute myocarditis. Within hours of presentation to the emergency department, she had cardiac arrest due to fulminant heart failure. Autopsy demonstrated necrotizing eosinophilic myocarditis. This is a rare cause of fulminant heart failure. This is the first report of a TNF-[alpha] antagonist potentially associated with acute necrotizing eosinophilic myocarditis.

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