Inflammatory demyelinating events following treatment with anti-tumor necrosis factor |
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| Authors: | A Fromont J De Seze MC Fleury JF Maillefert T Moreau |
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| Institution: | 1. Department of Neurology, University Hospital of Dijon, 21000 Dijon, France;2. Department of Neurology, University Hospital of Strasbourg, 67000 Strasbourg, France;3. Department of Rheumatology, University Hospital of Dijon, 21000 Dijon, France;1. Department of Medicine, Division of Cardiovascular Medicine, Advanced Cardiac Valve Center, University of Virginia, Charlottesville, Virginia;2. Department of Surgery, Division of Cardiothoracic Surgery, Advanced Cardiac Valve Center, University of Virginia, Charlottesville, Virginia;3. Department of Medicine, Division of Cardiovascular Medicine, Heart and Vascular Center, University of Virginia, Charlottesville, Virginia;4. Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan;1. Clinical Trial Resource Unit, St. Luke''s Hospital, St. Luke''s Radiation Oncology Centre, Highfield Road, Rathgar, Dublin 6, Ireland;2. Radiotherapy Department, St. Luke''s Hospital, St. Luke''s Radiation Oncology Centre, Highfield Road, Rathgar, Dublin 6, Ireland |
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| Abstract: | Background: Tumor necrosis factor alpha (TNF-α) is an inflammatory cytokine involved in certain inflammatory diseases including multiple sclerosis (MS), rheumatoid arthritis (RA), and Crohn’s disease. The anti-TNF-α treatments used for RA may be associated with inflammatory demyelinating events affecting the central nervous system and may possibly aggravate known MS. Objective: We report here three new cases of inflammatory demyelinating events of the central nervous system following treatment with anti-TNF-α. Results: The neurological symptoms appeared on average 5 months after initiation of the treatment. For all patients, the inflammatory process was confirmed by brain magnetic resonance imaging. The symptoms totally or partially regressed as soon as anti-TNF-α treatment was stopped except for one patient who developed clinically defined MS. Conclusions: Inflammatory demyelination of the central nervous system may be associated with the use of anti-TNF-α. Patients with rheumatoid arthritis treated with these treatments should benefit from a follow-up which includes brain MRI. |
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