TY - JOUR
T1 - TNF-alpha inhibitor associated myelopathies
T2 - A neurological complication in patients with rheumatologic disorders
AU - Barreras, Paula
AU - Mealy, Maureen A.
AU - Pardo-Villamizar, Carlos A
PY - 2017/2/15
Y1 - 2017/2/15
N2 - 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.
AB - 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.
KW - Spinal cord
KW - TNF
KW - TNF-alpha inhibitors
KW - Transverse myelitis
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U2 - 10.1016/j.jns.2017.01.023
DO - 10.1016/j.jns.2017.01.023
M3 - Article
C2 - 28131210
AN - SCOPUS:85009070836
SN - 0022-510X
VL - 373
SP - 303
EP - 306
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
ER -