J Rheum Dis.  2013 Jun;20(3):177-180. 10.4078/jrd.2013.20.3.177.

Multifocal Motor Neuropathy with Conduction Blocks During TNF-alpha Antagonist Therapy in a Patient with Spondyloarthropathy

• Kim RB
• Kang DH
• Lee SY
• Han JS
• Lim SK
• Song SH
• Seo YI
• Kim HA

• KMID: 2222757
• DOI: http://doi.org/10.4078/jrd.2013.20.3.177

Abstract

Tumor necrosis factor (TNF)-alpha antagonist has been proven to have benefit for rheumatologic diseases. Because TNF-alpha is not only an important mediator of inflammation in human body, but plays many physiologic roles, it can cause unique adverse effects or complications related to these functions. Adverse effects involving neurological systems, such as Guillain-Barre syndrome, Chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy with conduction blocks (MMNCB), distal symmetric polyneuropathy, and small fibers neuropathy have been previously reported. However, only several cases of infliximab-associated MMNCB are reported. We report a case of MMNCB which developed while treating spondyloarthropathy with infliximab.

Keyword

Infliximab; TNF-alpha antagonist; Multifocal motor neuropathy with conduction blocks

MeSH Terms

Antibodies, Monoclonal
Guillain-Barre Syndrome
Human Body
Humans
Inflammation
Polyneuropathies
Spondylarthropathies
Tumor Necrosis Factor-alpha
Infliximab
Antibodies, Monoclonal
Tumor Necrosis Factor-alpha

Figure

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  Figure 1. Serial motor nerve conduction studies of the right median nerve and left radial nerve among the 4 months. (A, B) The first study was done at 14 days after symptom onset, muscle response after stimu-lation at the axilla is 50% reduced in amplitude and area as compared with that after more distal stimu-lation at the forearm. This fits the definition of focal motor conduction block across that nerve segment. (C, D) Four months after stopping infliximab, the conduction blocks had slightly improved in the right median nerve and left radial nerve. APB: abductor pollicis brevis, EIP: extensor indicis proprius.

Reference

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