Is Discontinuation of Etanercept Necessary?
To the Editor: Eye involvement is a frequent event in pediatric and adult rheumatologic patients. Tumor necrosis factor (TNF) may play a role in experimental uveo-retinitis. In scleritis, TNF and interleukin 1 released by the local inflammatory cell infiltrate may be associated with sclera destruction1,2. Treatment with anti-TNF, therefore, is a logical approach to this problem. Indeed, such treatment has been reported to be successful in intractable cases of juvenile rheumatoid arthritis (JRA) associated uveitis, seronegative spondyloarthropathies, rheumatoid scleritis, and Behet’s disease3-6. There is one report, however, of anti-TNF treatment precipitating inflammatory eye disease5. Clinicians may face the dilemma of whether discontinuation of etanercept is necessary. We describe 2 cases of anterior uveitis and severe scleritis occurring in patients undergoing chronic etanercept treatment. In our patients, local and systemic immunosuppressive treatment were curative without disconti
