title: Acute paraplegia after the initiation of anti-tumour necrosis factor-alpha therapy for Crohn's disease.
abstract: Therapies aimed at inhibiting tumour necrosis factor are currently successfully administered to an increasing number of patients with autoimmune diseases. Infliximab has been approved to induce and maintain remission in Crohn's disease and fistulizing Crohn's disease. We report a case of acute-onset flaccid paraplegia after the initiation of anti-tumour necrosis factor therapy (infliximab) for Crohn's disease. Neuroimaging findings revealed an extensive longitudinal myelopathy. Two months later, no abnormal signal intensity was observed in the spinal cord and after 4 months, the patient presented improvement of motor function. A possible correlation between anti-tumour necrosis factor therapy and acute myelitis is discussed. This case highlights that patients developing new neurological symptoms while on anti-tumour necrosis factor medication should be monitored closely.
authors.affiliation: Department of Neurology, University Hospital, Democritus University of Thrace, Alexandroupolis, Greece. vadikosm@yahoo.com
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vadikolias
authors.forename: George
authors.initials: G
authors.lastname: Kouklakis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Heliopoulos
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Argyropoulou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papanas
authors.forename: Maria
authors.initials: M
authors.lastname: Tzilonidou
authors.forename: Panos
authors.initials: P
authors.lastname: Prassopoulos
authors.forename: Haritomeni
authors.initials: H
authors.lastname: Piperidou
mesh_terms: D000208:Acute Disease; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D003424:Crohn Disease / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D006801:Humans; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000139:chemically induced / Q000175:diagnosis; D010264:Paraplegia / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab