Skip to main content

Advertisement

Log in

A case of spontaneously recovering multifocal motor neuropathy with conduction blocks (MMNCB) during anti-TNF alpha therapy for ankylosing spondylitis

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

We report the case of a 54-year-old patient affected by ankylosing spondylitis who developed multifocal motor neuropathy with conduction blocks after 8 months of infliximab treatment. TNF alpha antagonist therapy has been associated with the development of both central nervous system and peripheral nervous system disorders, mainly of the demyelinating type. To our knowledge, this seems to be the second reported case of infliximab-related typical multifocal motor neuropathy with conduction blocks in which no other underlying causes of neuropathy were present. It is also the first in which typical multifocal motor neuropathy with conduction blocks spontaneously recovered without Ig.ev treatment and did not reappear over a long follow-up period. In our opinion, this strengthens the hypothesis of an actual adverse effect of infliximab in this patient. Finally, our case is the first one occurring in a patient with ankylosing spondylitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Nobile-Orazio E, Cappellari A, Priori A (2005) Multifocal motor neuropathy: current concepts and controversies. Muscle Nerve 31(6):663–680

    Article  PubMed  Google Scholar 

  2. Mohan N, Edwards ET, Cupps TR, Oliverio PJ, Sandberg G, Crayton H, Richert JR, Siegel JN (2001) Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 44(12):2862–2869

    Article  PubMed  CAS  Google Scholar 

  3. Stübgen JP (2008) Tumor necrosis factor-alpha antagonists and neuropathy. Muscle Nerve 37:281–292

    Article  PubMed  Google Scholar 

  4. Przemyslaw JK, Sliwinska-Kotyla B, Kucharz EJ (2007) Treatment with infliximab may contribute to the development of peripheral neuropathy among the patients with rheumatoid arthritis. Clin Rheumatol 26(9):1595–1596

    Article  Google Scholar 

  5. Mohan N, Edwards ET, Cupps TR, Oliverio PJ, Sandberg G, Crayton H, Richert JR, Siegel JN (2001) Demyelination occurring during anti-tumor necrosis factor alpha therapy for inflammatory arthritides. Arthritis Rheum 44(12):2862–2869

    Article  PubMed  CAS  Google Scholar 

  6. Rodriguez-Escalera C, Belzunegui J, Lopez-Dominguez L, Gonzalez C, Figueroa M (2005) Multifocal motor neuropathy with conduction block in a patient with rheumatoid arthritis on infliximab therapy. Rheumatology 44(1):132–133

    Article  PubMed  CAS  Google Scholar 

  7. Singer OC, Otto B, Steinmetz H, Ziemann U (2004) Acute neuropathy with multiple conduction blocks after TNF alpha monoclonal antibody therapy. Neurology 63(Nov):1754

    PubMed  Google Scholar 

  8. Cocito D, Bergamasco B, Tavella A, Poglio F, Prolasso I, Costa P, Ciaramitaro P, Isoardo G (2005) Multifocal motor neuropathy during treatment with infliximab. J Peripher Nerv Sys 10(4):386–387

    Article  Google Scholar 

  9. Tektonidou MG, Serelis J, Skopouli FN (2007) Peripheral neuropathy in two patients with rheumatoid arthritis receiving infliximab treatment. Clin Rheumatol 26(2):258–260

    Article  PubMed  Google Scholar 

  10. Fardet L, Dupuy A, Kerob D, Levi A et al (2007) Infliximab for severe hidradenitis suppurativa: transient clinical efficacy in 7 consecutive patients. J Am Acad Dermatol 56(4):624–628

    Article  PubMed  Google Scholar 

  11. Birnbaum J (2007) Infliximab-associated neuropathy in RA patients—the importance of considering the diagnosis of mononeuritis multiplex. Clin Rheumatol 26(2):281–282

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susanna Peccatori.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Paolazzi, G., Peccatori, S., Cavatorta, F.P. et al. A case of spontaneously recovering multifocal motor neuropathy with conduction blocks (MMNCB) during anti-TNF alpha therapy for ankylosing spondylitis. Clin Rheumatol 28, 993–995 (2009). https://doi.org/10.1007/s10067-009-1174-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-009-1174-3

Keywords

Navigation