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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMJ+Case+Rep 2015 ; 2015 (ä): ä Nephropedia Template TP
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A case of neurosarcoidosis secondary to treatment of etanercept and review of the literature #MMPMID26150616
Berrios I; Jun-O'Connell A; Ghiran S; Ionete C
BMJ Case Rep 2015[]; 2015 (ä): ä PMID26150616show ga
There are only three cases in the literature that describe development of neurosarcoidosis in a patient who is on tumour necrosis factor ? inhibitors. We describe a case of a 33-year-old woman with a history of juvenile rheumatoid arthritis and refractory uveitis (with previous treatment trials of adalimumab, infliximab, mycophenolate, methotrexate) who had been stable for 2?years on etanercept. She was diagnosed with biopsy-proven systemic sarcoidosis with meningeal and parenchymal neurosarcoidosis. She was switched to infliximab and methotrexate, with clinical and imaging improvements. This is a case that demonstrates the difficulty of choosing tumour necrosis factor ? (TNF-?) inhibitors when treating patients with multiple clinical autoimmune entities. It is also a case where a change in the mechanism of TNF-? inhibition pathway can still be used to treat refractory sarcoidoisis and rheumatoid arthritis. It is still unclear what the exact difference between the TNF-? blockers and their neurological complications is, and who the patients at risk of developing neurological complications are.