Polyneuropathy developing after infliximab therapy in a patient with recalcitrant pyoderma gangrenosum

Singer, Ralfi; �rken, Cihat; G�ng�r, �ule; �opur, Mehmet; K�z�lta�, Utkan; K�z�lta�, K�bra; Kocat�rk G�nc�, Emek; �engiz Erhan, Selma

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Polyneuropathy developing after infliximab therapy in a patient with recalcitrant pyoderma gangrenosum [Turkderm-Turk Arch Dermatol Venereol]

Turkderm-Turk Arch Dermatol Venereol. 2019; 53(1): 24-27 | DOI: 10.4274/turkderm.galenos.2018.70437

Polyneuropathy developing after infliximab therapy in a patient with recalcitrant pyoderma gangrenosum

Ralfi Singer¹, Cihat �rken², �ule G�ng�r¹, Mehmet �opur¹, Utkan K�z�lta�¹, K�bra K�z�lta�¹, Emek Kocat�rk G�nc�¹, Selma �engiz Erhan³
¹�stanbul Okmeydan� Training and Research Hospital, Clinic of Dermatology and Venereology, �stanbul, Turkey
²�stanbul Okmeydan� Training and Research Hospital, Clinic of Neurology, �stanbul, Turkey
³�stanbul Okmeydan� Training and Research Hospital, Department of Pathology, �stanbul, Turkey

The use of tumor necrosis factor-alpha (TNF-α) inhibitors has increased tremendously during the recent years. Neurological side effects associated with TNF-α inhibitors are rarely encountered, but these side effects may result in serious clinical problems. Treatment with TNF-α inhibitors is associated with demyelinating syndromes which can affect both the central and peripheral nervous systems. Short-term follow-up indicates relatively good outcomes, sometimes after just treatment discontinuation, although corticosteroids or intravenous immunoglobulin may be necessary to reverse the conditions in some cases. Here, we present a case of motor neuropathy developing after treatment with infliximab in a patient with recalcitrant pyoderma gangrenosum.

Keywords: TNF-α, inhibitors, infliximab, polyneuropathy, pyoderma gangrenosum

�nfliksimab tedavisi sonras� polin�ropati geli�en tedaviye diren�li bir pyoderma gangrenosum olgusu

Ralfi Singer¹, Cihat �rken², �ule G�ng�r¹, Mehmet �opur¹, Utkan K�z�lta�¹, K�bra K�z�lta�¹, Emek Kocat�rk G�nc�¹, Selma �engiz Erhan³
¹�stanbul Okmeydan� E�itim ve Ara�t�rma Hastanesi, Deri ve Z�hrevi Hastal�klar� Klini�i, �stanbul, T�rkiye
²�stanbul Okmeydan� E�itim ve Ara�t�rma Hastanesi, N�roloji Klini�i, �stanbul, T�rkiye
³�stanbul Okmeydan� E�itim ve Ara�t�rma Hastanesi, T�bbi Patoloji B�l�m�, �stanbul, T�rkiye

T�m�r nekroz fakt�r�-alfa (TNF-α) inhibit�rlerinin bir�ok romatizmal ve otoimm�n hastal��n tedavisinde kullan�mlar� son y�llarda artm��t�r. TNF-α inhibit�rlerine ba�l� n�rolojik yan etkiler nadir g�r�lmelerine kar��n olduk�a ciddi komplikasyonlar olu�turabilirler. TNF-α inhibit�rleri hem santral hem de periferik sinir sistemine ili�kin demiyelinizan tablolara yol a�abilir. Klinik tablo, biyolojik ajan tedavisinin kesilmesi ile d�zelebildi�i gibi, baz� olgularda sistemik steroid veya intraven�z imm�noglob�lin tedavisine gereksinim duyulabilir. Burada, standart tedaviye diren�li piyoderma gangrenosum nedeniyle infliksimab tedavisi ba�lanmas�ndan sonra motor n�ropati geli�en bir olgu sunulmaktad�r.

Anahtar Kelimeler: TNF-α, inhibit�rleri, infliksimab, polin�ropati, piyoderma gangrenosum

Corresponding Author: Ralfi Singer, T�rkiye
Manuscript Language: Turkish

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