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Rheumatoid meningitis associated with infliximab.
Susan Seago1, Edana Stroberg1, Austin Metting1
1Baylor Scott & White Health, Temple, Texas.
Proceedings (Baylor University. Medical Center)
|April 2, 2016
Summary
Rheumatoid meningitis, a rare condition, can occur in patients treated with tumor necrosis factor alpha (TNF-α) inhibitors like infliximab. Neurologic symptoms in a patient on infliximab resolved when the drug was stopped and returned upon reinitiation.
Area of Science:
- Neurology
- Immunology
- Rheumatology
Background:
- Tumor necrosis factor alpha (TNF-α) inhibitors, such as infliximab, are used to treat various autoimmune and inflammatory conditions.
- Rheumatoid meningitis is an uncommon but serious complication of rheumatoid arthritis affecting the central nervous system.
Observation:
- A patient on long-term infliximab therapy developed neurologic symptoms mimicking transient ischemic attacks.
- These symptoms improved significantly after infliximab treatment was discontinued due to an unrelated infection.
- The patient's neurologic deficits recurred upon restarting infliximab therapy.
Findings:
- The case suggests a potential link between infliximab therapy and the development or exacerbation of rheumatoid meningitis.
- Neurologic symptom recurrence upon infliximab reinitiation supports a causal relationship.
Implications:
- Clinicians should consider rheumatoid meningitis in patients on TNF-α inhibitors presenting with new neurologic symptoms.
- Monitoring for neurologic complications is crucial in patients receiving TNF-α inhibitor therapy.
- Further research is warranted to elucidate the mechanisms underlying TNF-α inhibitor-associated rheumatoid meningitis.
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