Iovino Aniello, Aruta Francesco, Dubbioso Raffaele, Ruggiero Lucia, Tozza Stefano, Spina Emanuele, Manganelli Fiore, Iodice Rosa
Department of Neuroscience, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy.
Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
J Cent Nerv Syst Dis. 2020 Dec 20;12:1179573520973820. doi: 10.1177/1179573520973820. eCollection 2020.
Antagonists of tumour necrosis factor α (TNFα) are a common therapeutic choice for autoimmune diseases. Although they are effective and relatively safe, an increasing number of immune-mediated adverse events have been reported. Among these, neurological adverse effectsm such as consisting of demyelinating events in the central and peripheral nervous system were described. Demyelination of the central nervous system is a rare complication after treatment with TNFα antagonists. Here, we report a case of multiple sclerosis under treatment with TNFα antagonists and discuss its etiopathogenesis. This 45-year-old female patient developed signs and symptoms suggestive of primary progressive multiple sclerosis during treatment with adalinumab for nodular cystic acne, and magnetic resonance imaging of the patient showed typical lesions of demyelinating disease.
肿瘤坏死因子α(TNFα)拮抗剂是自身免疫性疾病常见的治疗选择。尽管它们有效且相对安全,但已有越来越多免疫介导的不良事件报道。其中,描述了神经学不良反应,如中枢和外周神经系统的脱髓鞘事件。中枢神经系统脱髓鞘是TNFα拮抗剂治疗后罕见的并发症。在此,我们报告1例在用TNFα拮抗剂治疗期间发生多发性硬化症的病例,并讨论其发病机制。该45岁女性患者在使用阿达木单抗治疗结节性囊性痤疮期间出现提示原发性进行性多发性硬化症的体征和症状,患者的磁共振成像显示有脱髓鞘疾病的典型病变。