Vol.22 No.2

Case Report

Demyelination during anti-TNFα therapy for ankylosing spondylitis

Authors

Cecilia Mercieca1 , Norbert Vella2 , Andrew A. Borg3

  • Royal National Hospital for Rheumatic Diseases, Bath, UK
  • Neurology Department, Mater Dei Hospital, Msida, Malta
  • Rheumatology Department, Mater Dei Hospital, Birkirkara Bypass, Msida, 2090, Malta
Received:

31 March 2011

Accepted:

22 June 2011

Published online:

12 July 2011

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Abstract

A 34-year-old ankylosing spondylitis (AS) patient on etanercept for 30 months presented to neurologists with paresthesia of his hands and feet. Magnetic resonance imaging (MRI) scans showed multifocal hyperintense lesions. Symptoms did not improve on stopping the anti-tumor necrosis factor (TNF) agent. Few cases of demyelinating disease occurring after more than 2 years of treatment with anti-TNF agents have been reported in patients with AS. Opthalmologists, internists, neurologists, and rheumatologists need to be aware of these adverse events, as patients may present to any of these specialties many years after treatment.

Key words

Ankylosing spondylitis - Demyelination - Anti-TNF - Etanercept - Adverse events