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Infliximab-induced aseptic meningitis

H Marotte, J E Charrin, P Miossec

    Lancet (London, England)
    |December 6, 2001
    PubMed

    Insights

    Aseptic meningitis occurred in a rheumatoid arthritis patient treated with infliximab, presenting as severe muscle pain and transient lymphocytic meningitis. This adverse reaction may stem from infliximab

    Area of Science:

    • Neurology
    • Rheumatology
    • Immunology

    Background:

    • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
    • Infliximab is a biologic therapy targeting tumor necrosis factor-alpha for RA.
    • Adverse drug reactions require thorough investigation.

    Observation:

    • A 53-year-old male patient with active RA experienced severe muscle pain post-infliximab infusion.
    • The patient developed transient lymphocytic meningitis after subsequent infusions.
    • Standard autoimmune markers and antibodies to neurons were not elevated.

    Findings:

    • No functional antibodies to infliximab were detected.
    • Elevated tumor necrosis factor-alpha levels in cerebrospinal fluid were not observed.
    • The meningitis was aseptic, suggesting an indirect mechanism.

    Implications:

    • This case suggests a potential link between infliximab and aseptic meningitis.
    • The inability of infliximab to cross the blood-brain barrier might explain the reaction.
    • Further research is needed to understand infliximab's central nervous system effects in RA patients.

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