{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:09:57Z","timestamp":1781150997930,"version":"3.54.1"},"reference-count":6,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anti\u2010TNF\u03b1 inhibitor\u2010induced Lupus (ATIL) is a rare syndrome characterized by a wide array of symptoms ranging from skin manifestations to organ\u2010specific symptoms such as pleural effusions, pericardial effusions, hepatotoxicity, etc. Infliximab is implicated in most cases, and ATIL usually develops between the first month and 4\u2009years of infliximab application. In this report, we present an interesting case of ATIL that developed rather gradually upon anti\u2010TNFa used to treat Crohn's disease. The patient presented with oral ulcers, photosensitive rash, diffuse alopecia, inflammation of the hands, and pleuritic chest pain. Comprehensive serological testing revealed the presence of antinuclear antibodies and anti\u2010DNA antibodies. During the evaluation, the patient developed headaches, followed by a brain MRI that suggested nonspecific white matter lesions. Given the chronic development of symptoms, invasive examinations such as an arteriogram were performed to exclude CNS vasculitis, which showed no evidence of the vasculitis. Therefore, in the absence of any clear radiographical signs of vasculitis, patients should not undergo invasive studies, including an angiogram. The CNS angiogram can be associated with several side effects, including damage to the blood vessel, bruising or bleeding at the puncture site, and infection, which can further aggravate ATIL. Although rare, ATIL should always be considered while evaluating a patient with suggestive symptoms on infliximab therapy. Further research on identifying the variety of clinical presentations of ATIL and the underlying pathophysiology can help improve health policy and clinical practice by reducing unnecessary examination and allowing early management and better\u2010quality care.<\/jats:p>","DOI":"10.1002\/ccr3.7673","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T04:38:34Z","timestamp":1689741514000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anti\u2010TNF\u03b1 induced lupus due to infliximab therapy in a patient with concurrent Crohn's disease"],"prefix":"10.1002","volume":"11","author":[{"given":"Akanksha","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Internal Medicine UPMC Mercy  Pittsburg Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine UPMC Mercy  Pittsburg Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2226-0906","authenticated-orcid":false,"given":"Aashna","family":"Mehta","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Debrecen  Debrecen Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Birnbaum","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine UPMC Mercy  Pittsburg Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-3825","authenticated-orcid":false,"given":"Abhigan Babu","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine M Abdur Rahim Medical College  Dinajpur Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar1715"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)60668-X"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874312901206010315"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-019-2028-2"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.4.358"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.7673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T08:37:04Z","timestamp":1692261424000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.7673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":6,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/ccr3.7673"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.7673","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2023-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e7673"}}