Leukoencephalopathy during administration of etanercept for refractory rheumatoid arthritis

Motohisa YamamotoFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, JapanCorrespondence[email protected]

Hiroki TakahashiFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Hideki WakasugiFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Yasutaka SukawaFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Mayuko SaitoFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Chisako SuzukiFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Yasuyoshi NaishiroFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Hiroyuki YamamotoFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Yasuhisa ShinomuraFirst Department of Internal Medicine, Sapporo Medical University, School of Medicine,South 1-West 16, Chuo-ku, Sapporo 060-8543, Japan

Kohzoh ImaiSapporo Medical University,Sapporo, Japan

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Abstract

A 74-year-old Japanese woman was diagnosed with rheumatoid arthritis due to polyarthralgia. She was prescribed various disease-modifying anti-rheumatic drugs, but most of them were discontinued because of side effects or poor effectiveness. She was referred to our hospital in 2004, and etanercept was administered from June 2005. This resulted in rapid improvement of polyarthritis; however, she developed disorientation from February 2006. She was admitted to our hospital because of convulsions and loss of consciousness. She was diagnosed with progressive multifocal leukoencephalopathy on the basis of clinical symptoms and magnetic resonance imaging of the brain. In this significant and important case, leukoencephalopathy occurred during etanercept administration, and we refer to the risk of anti-TNFα drugs.

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Leukoencephalopathy during administration of etanercept for refractory rheumatoid arthritis

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Leukoencephalopathy during administration of etanercept for refractory rheumatoid arthritis

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