P ANTI-TNF INDUCED LUPUS X PT OF UC

 A

In a 19-year-old with ulcerative colitis receiving an anti-TNF agent, the most likely suspected diagnosis is:

Anti-TNF–induced lupus (drug-induced lupus erythematosus).

Anti-TNF therapies (e.g., infliximab, adalimumab) are well known to trigger a lupus-like syndrome, particularly in young patients with inflammatory bowel disease.

Why this is suspected:

• Development of new systemic symptoms after starting anti-TNF therapy

• Common features include:

  • Fever

  • Arthralgias

  • Rash (often malar or photosensitive)

  • Serositis

• Positive autoantibodies:

  • ANA

  • Anti–dsDNA (frequently present in anti-TNF–induced cases)

Key Point:

Anti-TNF–induced lupus typically improves after discontinuation of the biologic agent.

If you’d like, you can share the specific clinical details from the case (rash type, labs, timing, etc.), and I can help confirm whether this fits best or if another anti-TNF complication (e.g., serum sickness–like reaction, paradoxical psoriasis, infusion reaction) is more likely.