【Case1】49y.o.male. Adalimumab (ADA) was introduced to the patients with rheumatoid Arthritis (RA) due to insufficiency effect of treatment with methotorexate (MTX) and mizoribine (MZR).He was hospitalized due to appearance of elevation of serum creatinekinase (CPK) and interstitial lung disease after the ADA treatment. The interstitial legion in chest X-rays was vanished after suspension of the ADA treatment. The patient was diagnosed as anti-aminoacyl tRNA synthetases (ARS) antibody syndrome because of myositis and presence of anti-EJ antibody. The disease was ameliorated by treatment with prednisolone (PSL) and tacrolimus (TAC).
【Case2】47y.o.female. Infliximab (IFX) was given to the patients with RA because insufficient effect of MTX treatment. She was hospitalized due to elevation of serum CPK level and appearance of interstitial lung disease after the IFX treatment. Although she was initially considered as polymyositis and treated with PSL and cyclosporine, she was diagnosed as anti-ARS antibody syndrome because anti PL-7antibody was detected in the course of hospitalization.
【Conclusion】This report suggested that blockade of TNF-α is a risk for onset of anti-ARS antibody syndrome. We should take into account for appearance or worsening of pulmonary complication and/or myositis after usage of such agents.