title: Demyelination during anti-TNFα therapy for ankylosing spondylitis.
abstract: A 34-year-old ankylosing spondylitis (AS) patient on etanercept for 30 months presented to neurologists with paresthesia of his hands and feet. Magnetic resonance imaging (MRI) scans showed multifocal hyperintense lesions. Symptoms did not improve on stopping the anti-tumor necrosis factor (TNF) agent. Few cases of demyelinating disease occurring after more than 2 years of treatment with anti-TNF agents have been reported in patients with AS. Opthalmologists, internists, neurologists, and rheumatologists need to be aware of these adverse events, as patients may present to any of these specialties many years after treatment.
authors: Royal National Hospital for Rheumatic Diseases, Bath, UK.
authors: Cecilia
authors: C
authors: Mercieca
authors: Norbert
authors: N
authors: Vella
authors: Andrew A
authors: AA
authors: Borg
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects*; D003711:Demyelinating Diseases / Q000139:chemically induced* / Q000473:pathology; D057915:Drug Substitution; D000068800:Etanercept; D005528:Foot / Q000473:pathology; D006225:Hand / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D010292:Paresthesia / Q000139:chemically induced* / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D028761:Withholding Treatment
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept