Dramatic MRI improvement with refractory neurosarcoidosis treated with infliximab.
BACKGROUND
Neurosarcoidosis is often a devastating, refractory condition without definite pharmacotherapies beyond corticosteroids.


OBJECTIVE
To describe a case of steroid-refractory neurosarcoidosis with a marked clinical and radiological response to infliximab.


METHODS
We describe the case of a young female patient with biopsy-proven neurosarcoidosis leading to gait failure. She described significant corticosteroid-related side effects without clinical response to the therapy. Infliximab therapy was considered as a possible rescue medication.


RESULTS
Within months of starting intravenous infliximab therapy, she regained her ability to walk and magnetic resonance imaging identified significant improvements over a sustained course of infliximab therapy, including loss of enhancing nodules and loss of meningeal enhancement.


CONCLUSIONS
Mounting evidence suggests that infliximab is a valuable pharmacological agent in the management of patients with refractory and disabling neurosarcoidosis. Controlled studies of infliximab in this condition are needed.
Toth
C
C
Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. corytoth@shaw.ca
Martin
L
L
Morrish
W
W
Coutts
S
S
Parney
I
I
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002493:Central Nervous System Diseases / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D012507:Sarcoidosis / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome