title: [Meningeal and Guillain-Barrè syndrome in a patient with rheumatoid arthritis receiving adalimumab therapy].
abstract: Adalimumab is a recombinant human monoclonal antibody that blocks the effects of tumor necrosis factor-alpha, and is presently used for treatment of rheumatoid arthritis, with demyelination being a potential adverse effect. A 31 year-old male with seropositive rheumatoid arthritis presented with diarrhea after the second injection of adalimumab. He was treated with ciprofloxacin. In a few days he developed a Guillain-Barrè syndrome confirmed by electromyography, and his cerebrospinal fluid was compatible with meningeal syndrome or partially treated bacterial meningitis. Adalimumab may be associated with the development of demyelination and infectious diseases. Moreover, both the central nervous system and the peripheral nervous system can be affected.
authors.affiliation: Servicio de Neurología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España. plm_mf@hotmail.com
authors.forename: Pino
authors.initials: P
authors.lastname: López Méndez
authors.forename: Idaira
authors.initials: I
authors.lastname: Martín Santana
authors.forename: María
authors.initials: M
authors.lastname: del Pino Reyes Yánez
authors.forename: Arminda
authors.initials: A
authors.lastname: Ruano Hernández
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Hernández Beriain
authors.forename: Miguel
authors.initials: M
authors.lastname: Hervás García
mesh_terms: D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005759:Gastroenteritis / Q000139:chemically induced / Q000150:complications; D020275:Guillain-Barre Syndrome / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D000068879:Adalimumab