Cereda C W, Zecca C, Mazzucchelli L, Valci L, Staedler C, Bassetti C L, Gobbi C
Neurology, Neurocenter of Southern Switzerland, Lugano, Switzerland.
Mult Scler. 2013 May;19(6):820-3. doi: 10.1177/1352458512461969. Epub 2012 Oct 15.
Tumor necrosis factor alpha (TNF-α) is a pro-inflammatory and immunoregulatory cytokine involved in the pathogenesis of several autoimmune disorders. Etanercept, a TNF-α antagonist (anti-TNF-α) acting as a soluble TNF-α receptor, has been associated with neurological demyelinating disorders. This paper aims to report an unusual case showing tumefactive central nervous system (CNS) inflammatory demyelination in a patient in the course of TNF -α antagonist therapy, requiring decompressive hemicraniectomy. This report is based on magnetic resonance imaging (MRI) findings and histology. A biopsy confirmed the inflammatory demyelinating nature of the lesions. The clinical presentation is unusual due to the severity of the disease process, requiring decompressive hemicraniotomy with a clinically favorable outcome.
肿瘤坏死因子α（TNF-α）是一种促炎和免疫调节细胞因子，参与多种自身免疫性疾病的发病机制。依那西普是一种作为可溶性TNF-α受体起作用的TNF-α拮抗剂（抗TNF-α），与神经脱髓鞘疾病有关。本文旨在报告一例不寻常病例，该病例显示一名患者在接受TNF-α拮抗剂治疗过程中出现肿胀性中枢神经系统（CNS）炎性脱髓鞘，需要进行减压性颅骨切除术。本报告基于磁共振成像（MRI）结果和组织学。活检证实了病变的炎性脱髓鞘性质。由于疾病过程的严重性，临床表现不寻常，需要进行减压性颅骨切开术，临床结果良好。
