Demyelinating neuropathy during anti-TNF alpha treatment with a review of the literature

Introduction. Tumor necrosis factor- (TNF) blockers are efficient in the treatment of autoimmune disorders such as inflammatory bowel disease and rheumatoid arthritis, but can induce CNS adverse effects including retrobulbar optic neuritis or aggravation of multiple sclerosis. Observation. We report a case of progressive demyelinating polyneuropathy after initiation of Adalimumab (Humira (R)). Corticosteroid and intravenous immunoglobulins were ineffective but the neuropathy improved within six months after adalimunab discontinuation. Discussion. This case, and other reports recently published suggest that anti-TNF alpha drugs can induce demyelinating neuropathy. Conclusion. Clinicians should be on the lookout for signs evocating neuropathy in patients given anti TNF alpha.