<qa>  How many patients will be randomized to receive etanercept?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. 