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

Melissa Padovan (1) , Luisa Maria Caniatti (2) , Francesco Trotta (1) , Marcello Govoni (1)

1 Rheumatology Unit, Department of clinical and experimental medicine
2 Neurology Unit, Department of Neurosciences

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.

Mots clés: Rheumatoid arthritis; Amyotrophic lateral sclerosis (ALS); Tumor necrosis factor alpha (TNFα) blockers; Motor neuron disease (MND)

Melissa Padovan, Luisa Maria Caniatti, Francesco Trotta, Marcello Govoni. Concomitant rheumatoid arthritis and amyotrophic lateral sclerosis: report of two new cases and review of literature. Rheumatology International, 2011, 31 (6), pp.715-719. ⟨10.1007/s00296-010-1760-3⟩. ⟨hal-00661976⟩