IngentaConnect Dramatic MRI improvement with refractory neurosarcoidosis treated...

Authors: Toth, C.¹; Martin, L.²; Morrish, W.³; Coutts, S.¹; Parney, I.¹

Source: Acta Neurologica Scandinavica, Volume 116, Number 4, October 2007 , pp. 259-262(4)

Abstract:

Toth C, Martin L, Morrish W, Coutts S, Parney I. Dramatic MRI improvement with refractory neurosarcoidosis treated with infliximab.

Acta Neurol Scand 2007: 116: 259-262.

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.

Keywords: corticosteroids; infliximab; neurosarcoidosis; sarcoidosis; tumor necrosis factor α inhibitors

Document Type: Research article

DOI: 10.1111/j.1600-0404.2007.00870.x

Affiliations: 1: Department of Clinical Neurosciences 2: Internal Medicine 3: Diagnostic Imaging, University of Calgary and Calgary Health Region, Calgary, AB, Canada

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