Golimumab-Induced Anti-NuMA-1 (Nuclear Mitotic Apparatus Protein 1) Antibodies in a Rheumatoid Arthritis Patient: A Case Report

Anti-nuclear mitotic apparatus (NuMA) 1 antibodies are uncommonly detected in routine antinuclear antibody (ANA) screening. We present the case of a 65-year-old female with rheumatoid arthritis undergoing golimumab biotherapy who developed lupus-like symptoms including photosensitivity, fatigue, weakness, myalgias, alopecia, oral ulcers, and worsening of arthritis. Elevated serum levels of NuMA-1 antibodies were detected using indirect immunofluorescence (IIF) on HEp-2 cells with a titer of 1:1000, but no other ANA patterns were associated. The patient's symptoms were successfully treated with oral prednisone, leading to complete resolution. This case highlights a potential association between golimumab and the induction of NuMA-1 antibodies, a previously unreported phenomenon, emphasizing the importance of vigilant monitoring for patients receiving golimumab, especially those with risk factors for autoimmune disorders, to early detect lupus-like symptoms and prevent complications.