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Concomitant rheumatoid arthritis and amyotrophic lateral sclerosis: report of two new cases and review of literature

2011; Springer Science+Business Media; Volume: 31; Issue: 6 Linguagem: Inglês

10.1007/s00296-010-1760-3

1437-160X

Melissa Padovan, Luisa Caniatti, Francesco Trotta, Marcello Govoni,

Amyloidosis: Diagnosis, Treatment, Outcomes

To describe a rare association between rheumatoid arthritis (RA) and amyotrophic lateral sclerosis (ALS). Two new cases of patients with RA who developed amyotrophic lateral sclerosis (ALS), one receiving anti-TNFα agents, were reported. Only other five cases of this rare association have been previously described in literature. The simultaneous presence of the two diseases represents a difficult diagnostic challenge because RA may mimic some musculoskeletal symptoms of ALS. There is no evidence in favor of a common pathophysiologic mechanism, and thus the possibility of a fortuitous association must be raised. A neurotoxic side effect of various drugs for RA treatment could be considered. Casual or causal association remains a difficult choice. The possibility of a coincidental association must be raised but neurologic side effects of TNFα blockers lead to discussion.