title: Adalimumab treatment may replace or enhance the activity of steroids in steroid-refractory tuberculous meningitis.
abstract: We describe a paradoxical response involving the central nervous system in a patient with steroid-refractory tuberculous meningitis that was unresponsive to systemic corticosteroids but was improved with adalimumab. The immunomodulatory effect of tumor necrosis factor inhibitors may have a role in replacing or enhancing the activity of steroids in the management of steroid-refractory tuberculous meningitis.
authors: Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poonganp dong, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors: Ho-Su
authors: HS
authors: Lee
authors: Yumi
authors: Y
authors: Lee
authors: Sang-Oh
authors: SO
authors: Lee
authors: Sang-Ho
authors: SH
authors: Choi
authors: Yang Soo
authors: YS
authors: Kim
authors: Jun Hee
authors: JH
authors: Woo
authors: Sung-Han
authors: SH
authors: Kim
mesh_terms: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D004357:Drug Synergism; D006801:Humans; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use*; D014390:Tuberculosis, Meningeal / Q000188:drug therapy* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000995:Antitubercular Agents; D013256:Steroids; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab