Treatment of refractory neurosarcoidosis with Infliximab.
BACKGROUND
Neurological involvement in sarcoidosis is serious and often aggressive. Many patients respond to steroids but some show a progressive course despite treatment with steroids and even more potent immunosuppressive drugs.


OBJECTIVE
The aim of this study was to describe our experience in the treatment of refractory neurosarcoidosis with Infliximab--its effect on the course of the disease and side effects.


METHODS
A series of four patients are reported with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used.


RESULTS
A good response, with improvement or stabilisation of the neurological condition, was seen in all cases, without significant side effects. Infliximab is a chimeric monoclonal antibody that neutralises the biological activity of tumour necrosis factor alpha, a cytokine thought to play an important role in the pathophysiology of sarcoidosis.


CONCLUSIONS
Our experience using Infliximab adds to the growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.
Santos
Ernestina
E
Neurology Department, Hospital Geral Santo António, Porto, Portugal.
Shaunak
Sandip
S
Renowden
Shelley
S
Scolding
Neil J
NJ
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy*; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab