Refractory rheumatoid factor positive polyarthritis in a female adolescent already suffering from type 1 diabetes mellitus and Hashimoto’s thyroiditis successfully treated with etanercept

Olivieri, Alma Nunzia; Iafusco, Dario; Antonio, Martín; Zanfardino, Angela; Mauro, Angela; Granato, Carmela; Gicchino, Maria Francesca; Prisco, Francesco; Perrone, Laura

doi:10.1186/1824-7288-39-64

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…Although there are no other trials of TNF inhibitors for diabetes treatment, there are case reports of patients with autoimmune diabetes who experienced improved glycemic control and/or hypoglycemia after initiating treatment with etanercept [80, 81], adalimumab [82–84], and infliximab [85], suggesting that the effects of etanercept on type 1 diabetes are generalizable to TNF inhibitors as a group. Of note, there are two reported cases of type 1 diabetes developing shortly after TNF inhibitors were started, raising the concern that TNF inhibitors were the cause [86, 87].…”

Section: Diabetes-specific Effects Of Rheumatologic Immune Modulatorsmentioning

confidence: 99%

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

et al. 2016

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Immune modulators used to treat rheumatologic disease have diverse endocrine effects in patients with diabetes. Providers should be aware of these effects given that diabetes and rheumatologic disease overlap in prevalence and cardiovascular morbidity. In patients with type 1 diabetes, clinical trials have demonstrated that immune modulators used early in the disease can improve pancreatic function, though their efficacy in adults with longstanding autoimmune diabetes is unknown. In patients with type 2 diabetes, hydroxychloroquine is an effective antihyperglycemic and may be preferred for rheumatologic use in patients with difficult glycemic control. In patients without diabetes, hydroxychloroquine and tumor necrosis factor (TNF) inhibitors have been found to decrease diabetes incidence in observational studies. Additionally, dapsone and sulfasalazine alter erythrocyte survival resulting in inaccurate HbA1c values. These multifaceted effects of immune modulators create a need for coordinated care between providers treating patients with diabetes to individualize medication selection and prevent hypoglycemic events. More research is needed to determine the long-term outcomes of immune modulators in patients with diabetes.

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Section: Diabetes-specific Effects Of Rheumatologic Immune Modulatorsmentioning

confidence: 99%

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

et al. 2016

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“…It can competitively combine with TNF-α and then block the combination of TNF-α and its receptor, resulting in inhibition of TNF-α activity (10). Several studies have demonstrated that etanercept is used to treat TNF-α-related diseases, such as rheumatoid arthritis (11), Crohn’s disease (12), ankylosing spondylitis (13), psoriasis (14), diabetes mellitus (15), Alzheimer disease (16) and cancers (17). Notably, increased level of TNF-α is found in patients with heart failure, and TNF-α has been proven to serve as a prognostic factor of heart failure (18).…”

Section: Introductionmentioning

confidence: 99%

Etanercept protects rat cardiomyocytes against hypertrophy by regulating inflammatory cytokines secretion and cell apoptosis

et al. 2017

Braz J Med Biol Res

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We aimed to investigate the effect of etanercept, a tumor necrosis factor-a (TNF-a) inhibitor, on rat cardiomyocyte hypertrophy and its underlying mechanism. Primary neonatal rat cardiomyocytes were isolated from Sprague-Dawley rats. The model of rat cardiomyocyte hypertrophy was induced by endothelin, and then treated with different concentrations of etanercept (1, 10, and 50 mM). After treatment, cell counts, viability and cell apoptosis were evaluated. The mRNA levels of myocardial hypertrophy marker genes, including atrial natriuretic factor (ANF), matrix metalloproteinase (MMP)-9 and MMP-13, were detected by qRT-PCR, and the expressions of apoptosis-related proteins (Bcl-2 and Bax) were measured by western blotting. The protein levels of transforming growth factor-b1 (TGF-b1), interleukin (IL)-1b, IL-6, leukemia inhibitory factor (LIF) and cardiotrophin-1 (CT-1) were determined using enzyme linked immunosorbent assay (ELISA) kits. In the present study, TNF-a level in cardiomyocytes with hypertrophy was significantly enhanced (Po0.05). Compared to the model group, cell number and viability were significantly increased and ratio of apoptotic cells was reduced by etanercept (Po0.05, Po0.01, or Po0.001). In addition, etanercept remarkably reduced the mRNA levels of ANF, MMP-9 and MMP-13, inhibited the expression of Bax, and increased the expression of Bcl-2 compared to the model group (Po0.05). ELISA results further showed that etanercept lowered the levels of IL-1b, IL-6, LIF and CT-1 but not TGF-b1 compared to the model group (Po0.05). Etanercept may protect rat cardiomyocytes from hypertrophy by inhibiting inflammatory cytokines secretion and cell apoptosis.

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“…The management of DM is a great challenge especially in adolescents ( 4 , 5 ). The adolescents with from type 1 DM are on the verge of being independent from their families but the disease hinders their relations with others ( 6 ). Nowadays one of the most significant health problems in developed as well as developing societies is increasing prevalence of DM, which puts financial burden on the affected families and the societies and causes psychologic problems for the patients and families.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Group Discussion on the Quality of Life and HbA1c Levels of Adolescents With Diabetes

Afshar

Memarian

Mohammadi

2014

Iran Red Crescent Med J

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Background:Diabetes is a metabolic syndrome and the most common endocrine disorder in childhood and adolescence. Diabetes occurs at any age but the highest outbreak is during ten to 15 years of age and 75% of the cases are diagnosed at the age 18.Objectives:This study aimed to investigate the effect of a group discussion on the quality of life (QOL) and glycosylated hemoglobin A (HbA1c) levels of adolescents with diabetes.Patients and Methods:This quasi-experimental study was performed on 56 adolescents with diabetes who were referred to Golabchi Diabetes Center in Kashan, Iran. After obtaining written informed consent from the patients, blood sample was drawn for measuring sugar and HbA1c levels. The participants completed the questionnaire regarding the QOL. Patients were randomly allocated to four groups. All the groups attended similar group discussion sessions, which were conducted according to the guidance of diabetic specialists. The groups’ members followed the discussed instructions for four months. Then, another questionnaire was completed and blood sugar and HbA1c levels were measured again. The results were compared by paired-samples t-test and Wilcoxon signed-rank test.Results:After the group discussion sessions, in 56% of the patients the HbA1c levels (8.45 ± 1.35 and 6.98 ± 0.89 before and after intervention, respectively) and QOL were improved significantly. The mean age of these patients was 14.75 ± 1.80 years and the mean of daily insulin injection was 35.70 ± 13.42 units.Conclusions:Sharing experiences trough group discussions and receiving instructive feedbacks can improve the QOL and metabolic status of adolescents with diabetes.

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Refractory rheumatoid factor positive polyarthritis in a female adolescent already suffering from type 1 diabetes mellitus and Hashimoto’s thyroiditis successfully treated with etanercept

Cited by 9 publications

References 23 publications

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

Etanercept protects rat cardiomyocytes against hypertrophy by regulating inflammatory cytokines secretion and cell apoptosis

The Effect of Group Discussion on the Quality of Life and HbA1c Levels of Adolescents With Diabetes

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