This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Immunomodulatory: DMARDS, Monoclonal Antibodies, Subject name: Pharmacology
Anti-TNF alpha drugs are used for the treatment of all of following diseases except 
Select and explain. 
A. Systemic lupus erythematosis, B. Seronegative arthritis, C. Psoriatic arthritis, D. Crohn's disease
A: Systemic lupus erythematosis
Answer: A: Systemic lupus erythematosis 
Explanation: Ans. (A) Systemic lupus erythematosus(Ref: Harrison 17/e p2039; KDT 8/e p943)There is already under-expression of TNF-a in SLE, therefore we cannot use anti-TNF drugs for this condition. It is further strengthened by the fact that anti-TNF alpha drugs like infliximab cause SLE as the adverse effect.Indications for TNF-a inhibitorsRheumatoid arthritisJuvenile arthritisPsoriatic arthritisPsoriasisAnkylosing spondylitisCrohn's disease