Lewis-Sumner syndrome associated with infliximab therapy in rheumatoid arthritis.
We report 2 cases of Lewis-Sumner syndrome (LSS) diagnosed in patients suffering from rheumatoid arthritis undergoing treatment with the antitumor necrosis factor alpha (TNF-alpha) monoclonal antibody infliximab. While experiencing clinical improvement in their arthritic symptoms, both patients experienced sensory deficits and weakness in multiple nerve distributions. They had electrodiagnostic evidence of motor conduction block and subsequent improvement with intravenous immunoglobulin (IVIg). We describe the details of the cases and review the literature on immune-mediated neuropathies associated with anti-TNF-alpha therapy.
Hooper
Davyd R
DR
Department of Medicine, Neuromuscular Disease Clinic, Rm. 2H22, McMaster University, Hamilton, Ontario, Canada, L8N 3Z5.
Tarnopolsky
Mark A
MA
Baker
Steven K
SK
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015551:Autoimmunity / Q000187:drug effects / Q000276:immunology; D004568:Electrodiagnosis; D005071:Evoked Potentials / Q000187:drug effects / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000187:drug effects / Q000276:immunology; D009431:Neural Conduction / Q000187:drug effects / Q000276:immunology; D010525:Peripheral Nerves / Q000187:drug effects / Q000276:immunology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000276:immunology* / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000139:chemically induced* / Q000276:immunology* / Q000503:physiopathology; D011984:Sensory Receptor Cells / Q000187:drug effects / Q000276:immunology; D013577:Syndrome; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D016756:Immunoglobulins, Intravenous; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab