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Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
Demyelination during anti-tumor necrosis factor alpha therapy with infliximab for Crohn's disease
Carlton W Thomas1, Brian G Weinshenker, William J Sandborn
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
Background:
Inflammatory demyelinating disease of the central nervous system may be linked to anti-tumor necrosis factor alpha therapy.
Case History:
A 19-year-old female with Crohn's ileocolitis developed right arm and leg numbness and right hand weakness 4 weeks after the initiation of infliximab. Neurologic examination confirmed upper and lower right extremity sensory and motor deficits. MRI examination of the head and thoracic cord showed multiple gadolinium-enhancing lesions with distribution and configuration most suggestive of multiple sclerosis or other demyelinating process. The infliximab therapy was immediately stopped and follow-up at 8 weeks revealed symptomatic improvement.
Conclusion:
This case report describes the onset of a demyelinating process after the institution of infliximab therapy in a patient with Crohn's disease.
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