Demyelination during anti-tumor necrosis factor alpha therapy with infliximab for Crohn's disease.
BACKGROUND
Inflammatory demyelinating disease of the central nervous system may be linked to anti-tumor necrosis factor alpha therapy.


METHODS
A 19-year-old female with Crohn's ileocolitis developed right arm and leg numbness and right hand weakness 4 weeks after the initiation of infliximab. Neurologic examination confirmed upper and lower right extremity sensory and motor deficits. MRI examination of the head and thoracic cord showed multiple gadolinium-enhancing lesions with distribution and configuration most suggestive of multiple sclerosis or other demyelinating process. The infliximab therapy was immediately stopped and follow-up at 8 weeks revealed symptomatic improvement.


CONCLUSIONS
This case report describes the onset of a demyelinating process after the institution of infliximab therapy in a patient with Crohn's disease.
Thomas
Carlton W
CW
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
Weinshenker
Brian G
BG
Sandborn
William J
WJ
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D003711:Demyelinating Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006987:Hypesthesia / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab