title: Leukoencephalopathy during administration of etanercept for refractory rheumatoid arthritis.
abstract: A 74-year-old Japanese woman was diagnosed with rheumatoid arthritis due to polyarthralgia. She was prescribed various disease-modifying anti-rheumatic drugs, but most of them were discontinued because of side effects or poor effectiveness. She was referred to our hospital in 2004, and etanercept was administered from June 2005. This resulted in rapid improvement of polyarthritis; however, she developed disorientation from February 2006. She was admitted to our hospital because of convulsions and loss of consciousness. She was diagnosed with progressive multifocal leukoencephalopathy on the basis of clinical symptoms and magnetic resonance imaging of the brain. In this significant and important case, leukoencephalopathy occurred during etanercept administration, and we refer to the risk of anti-TNFalpha drugs.
authors.affiliation: First Department of Internal Medicine, Sapporo Medical University, School of Medicine, South 1-West 16, Sapporo 060-8543, Japan. mocha@cocoa.plala.or.jp
authors.forename: Motohisa
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakasugi
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Sukawa
authors.forename: Mayuko
authors.initials: M
authors.lastname: Saito
authors.forename: Chisako
authors.initials: C
authors.lastname: Suzuki
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Naishiro
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Shinomura
authors.forename: Kohzoh
authors.initials: K
authors.lastname: Imai
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003128:Coma; D003704:Dementia; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000134:cerebrospinal fluid / Q000139:chemically induced*; D008279:Magnetic Resonance Imaging; D018124:Receptors, Tumor Necrosis Factor; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept