Adalimumab-induced central nervous system demyelination in a patient with rheumatoid arthritis.
Bader Hamza ShirahSamaher AltwirgiIrfan FaridoonSaeed AlghamdiPublished in: The neuroradiology journal (2023)
Adalimumab (Humira) is a human monoclonal antibody that belongs to the tumor necrosis factor (TNF) alpha antagonist class of medications. Central Nervous System (CNS) demyelination is a rare side effect of adalimumab, and only a few cases have been reported in the literature of patients who developed multiple sclerosis or other demyelinating patterns after using adalimumab. In this report, we present a case of CNS demyelination in a patient with rheumatoid arthritis that developed a few months after using adalimumab. Performing brain MRI for asymptomatic individuals prior to initiating anti-TNF alpha agents to exclude a pre-existing demyelinating disease may be worthwhile. Routine brain MRI for monitoring and surveillance may facilitate detecting cases early and avoid the development of permanent neurological disability. Further studies are needed to clarify the neurological safety of anti-TNF alpha agents.
Keyphrases
- rheumatoid arthritis
- multiple sclerosis
- disease activity
- monoclonal antibody
- white matter
- ankylosing spondylitis
- interstitial lung disease
- cerebral ischemia
- case report
- magnetic resonance imaging
- contrast enhanced
- blood brain barrier
- endothelial cells
- systematic review
- resting state
- public health
- high glucose
- cerebrospinal fluid
- computed tomography
- systemic sclerosis
- functional connectivity
- clinical practice
- drug induced
- subarachnoid hemorrhage
- magnetic resonance
- pluripotent stem cells
- brain injury
- induced pluripotent stem cells
- idiopathic pulmonary fibrosis