Serum Cytokine Concentrations in a Patient with Rheumatoid Arthritis on Etanercept Therapy Who Subsequently Developed Pneumocystis Pneumonia: A Case Report
Figure 3
Time course of serum cytokines concentrations. (a) TNF-alpha concentration increased between weeks 1 and 2 after the initiation of etanercept therapy then remained steady ranging from 100 pg/mL to 170 pg/mL. At 12 weeks, the patient developed PCP and the TNF-alpha value increased steeply (arrow). With cessation of etanercept, the TNF-alpha concentration immediately returned to pretreatment levels. Four weeks after the initiation of therapy, the TNFR-II concentration became steady, ranging from 300 ng/mL to 700 ng/mL. With cessation of etanercept due to the PCP, TNFR-II concentration returned to pretreatment levels. (b) On the other hand, at week 12, the levels of IL-6, CRP, and TNF-alpha showed an acute peak (arrow), which tapered downward over the following 3 weeks with the institution of an appropriate antifungal regimen.
