TNF-alpha inhibitor associated myelopathies: A neurological complication in patients with rheumatologic disorders.

Abstract:

OBJECTIVES:Tumor necrosis factor-alpha inhibitors (TNFα-I) are biological agents used in the treatment of rheumatologic disorders. TNFα-I have been associated with demyelinating disorders mimicking multiple sclerosis. The goal of this report is to illustrate cases of myelopathy which developed during the use of TNFα-I. METHODS:We describe the clinical, neuroimaging and laboratory features of 4 cases of myelopathy associated with TNFα-I. RESULTS:The mean period of TNFα-I exposure was 27 [12-36] months. Three of the four patients exhibited active inflammatory myelopathy as the spinal cord MRI lesions enhanced with gadolinium and CSF pleocytosis or oligoclonal bands were present. All patients had normal brain MRIs at the time of presentation. CONCLUSIONS:TNFα-I may play a role in the development of myelopathies in absence of brain involvement or other features of demyelinating disease. TNFα-I associated myelopathy should be considered in patients with history of treatment with TNFα-I who exhibit symptoms of myelopathy.

journal_name

J Neurol Sci

authors

Barreras P,Mealy MA,Pardo CA

doi

10.1016/j.jns.2017.01.023

subject

Has Abstract

pub_date

2017-02-15 00:00:00

pages

303-306

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(17)30024-2

journal_volume

373

pub_type

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