[Apperceptive form visual agnosia caused by anti-TNFalpha therapy to rheumatoid arthritis].
TNFalpha plays an important role as an inflammatory mediator in both several autoimmune diseases and multiple sclerosis. Anti-TNFalpha antibody has been widely used to treat rheumatoid arthritis and Crohn's disease. On the. other hand, anti-TNFalpha antibody treatment increased recurrence rate in clinical trials for multiple sclerosis. We report a patient with rheumatoid arthritis without past history of any neurological disorders, who developed diplopia, ataxia, and visual agnosia specific to line drawing in the course of anti-TNFalpha antibody treatment. MRI studies detected multiple demyelinating lesions in the cerebral white matter and brainstem. The present case indicates that careful observation of neurological symptoms is important in the course of anti-TNFalpha antibody treatment, even in patients without past history of demyelinating diseases.
Kobayashi
Shunsuke
S
Department of Neurology, Tokyo University.
Tanno
Makoto
M
Nakamura
Ichiro
I
Ito
Katsumi
K
Ugawa
Yoshikazu
Y
D000377:Agnosia / Q000139:chemically induced*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003711:Demyelinating Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab