title: [Guillain-Barré syndrome. Its association with alpha tumor necrosis factor].
abstract: BACKGROUND
  adalimumab, a human recombinant monoclonal antibody against tumoral necrosis factor alpha (TNFα), has been associated with central nervous system demyelinating diseases and peripheral neuropathic syndrome. The Guillain-Barré Syndrome (GBS) is one of them.
  
  
  METHODS
  we presented the case of a 65 year old woman, with diabetes mellitus and psoriasic arthritis, treated with adalimumab; after the fourth infusion, she developed paresthesia and mild weakness in lower limbs, these symptoms persisted three days after each infusion and each time remitted spontaneously; following the eight dose, presented a characteristic clinical picture of the GBS, confirmed with neurophysiological studies that showed an axonal motor-sensitive polyneuropathy. The treatment consisted in intravenous immunoglobulin, with good outcome.
  
  
  CONCLUSIONS
  the synergy among cellular and humoral immune responses, against peripheral nerve antigens is responsible of immunopathogenesis related to GBS. The prolonged and intensified pathologic immune response induced by adalimumab, may be associated to the development of GBS.
authors.affiliation: Departamento de Neurología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. elizabethsca@gmail.com
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Soto-Cabrera
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hernández-Martínez
authors.forename: Hiram
authors.initials: H
authors.lastname: Yáñez
authors.forename: Raúl
authors.initials: R
authors.lastname: Carrera
mesh_terms: D000068879:Adalimumab; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000139:chemically induced*; D006801:Humans; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab