Question of the Week

A 58-year-old man presents for a follow-up visit. A history of present illness reveals that he was admitted to the hospital with fever, diffuse arthralgias, rash, and pleuritic chest pain. His medical history includes seropositive rheumatoid arthritis, hypothyroidism, and diverticulosis. Laboratory testing was positive for ANA and anti-dSDNA antibodies. He was diagnosed with drug-induced lupus due to adalimumab and has reported the resolution of his symptoms since stopping that medication. He continues on methotrexate for seropositive rheumatoid arthritis. A review of systems is positive for significant morning stiffness, worsening joint pain, and swelling in his hands, wrists, elbows, and knees. The physical examination demonstrates synovitis in several joints, including the proximal interphalangeal, metacarpophalangeal, wrists, and metatarsophalangeal joints. Etanercept Tocilizumab Hydroxychloroquine Abatacept