Dramatic MRI improvement with refractory neurosarcoidosis treated with infliximab.

Abstract

BACKGROUND:

Neurosarcoidosis is often a devastating, refractory condition without definite pharmacotherapies beyond corticosteroids.

AIM:

To describe a case of steroid-refractory neurosarcoidosis with a marked clinical and radiological response to infliximab.

METHODS:

We describe the case of a young female patient with biopsy-proven neurosarcoidosis leading to gait failure. She described significant corticosteroid-related side effects without clinical response to the therapy. Infliximab therapy was considered as a possible rescue medication.

RESULTS:

Within months of starting intravenous infliximab therapy, she regained her ability to walk and magnetic resonance imaging identified significant improvements over a sustained course of infliximab therapy, including loss of enhancing nodules and loss of meningeal enhancement.

CONCLUSION:

Mounting evidence suggests that infliximab is a valuable pharmacological agent in the management of patients with refractory and disabling neurosarcoidosis. Controlled studies of infliximab in this condition are needed.

• Authors: C Toth, L Martin, W Morrish, S Coutts, I Parney
• Journal: Acta neurologica Scandinavica (Acta Neurol Scand) Vol. 116 Issue 4 Pg. 259-62 (Oct 2007) ISSN: 0001-6314 [Print] Denmark
• PMID: 17824906 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Infliximab

Topics

• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Central Nervous System Diseases (drug therapy, pathology)
• Female
• Humans
• Infliximab
• Magnetic Resonance Imaging
• Sarcoidosis (drug therapy, pathology)
• Treatment Outcome