Frontiers in Immunology (Sep 2024)

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

  • Benedetta Kassabian,
  • Monica Facco,
  • Alessandro Miscioscia,
  • Alessandro Miscioscia,
  • Samuela Carraro,
  • Francesca Rinaldi,
  • Paolo Gallo,
  • Paolo Gallo,
  • Marco Puthenparampil,
  • Marco Puthenparampil

DOI
https://doi.org/10.3389/fimmu.2024.1432360
Journal volume & issue
Vol. 15

Abstract

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Blood-brain barrier dysfunction might be driven by peripheral inflammation. TNFα inhibitors (TNF-αi) 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-αi -associated aseptic meningitis.

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