Case report: Breaking CNS immuno-privilege: TNFα-inhibitor triggers aseptic meningitis in a patient with rheumatoid arthritis

病例报告:打破中枢神经系统免疫豁免:TNFα抑制剂诱发类风湿性关节炎患者发生无菌性脑膜炎

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Abstract

Blood-brain barrier dysfunction might be driven by peripheral inflammation. TNFα inhibitors (TNF-α(i)) are occasionally associated with a wide spectrum of neurological immuno-mediated disorders. However, patients with systemic autoimmune disorders, including rheumatoid arthritis (RA), might be prone to develop further organ-specific, including central nervous system (CNS), autoimmunity. Here we report the case of a patient, affected by RA and treated with etanercept, who suddenly developed focal neurological symptoms. Cerebrospinal fluid, magnetic resonance imaging (MRI), and positron emission tomography (PET)/MRI findings are reported and support the diagnosis of TNF-α(i) -associated aseptic meningitis.

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