 Fifty six patients will be randomized to receive etanercept or identical placebo. During the screening visit, after informed consent is obtained, subjects will undergo a medical history and physical exam, which will include vital signs, weight, abdominal girth measurements and an evaluation for signs of underlying infection. A purified protein derivative PPD of 5 tuberculin units TU 0.1 milliliter of 5 TU0.1 ml solution will be intradermally placed to test for the presence of tuberculosis TB. Fasting blood work will include a complete blood count CBC, glucose, insulin, a cholesterol panel, and urine pregnancy test. Subjects will be shown what a subcutaneous injection entails using placebo. Patients will be selected based on their laboratory results, abdominal girth measurements and PPD negativity 48 hrs after placement. 