Adalimumab Induced Aseptic Meningitis and Focal Partial Seizures in Patient with Crohn’s Disease

Corey S. Ellis¹, Hayden L. Smith^1, and Lisa A Veach²

¹Graduate Medical Education, UnityPoint Health-Des Moines, Des Moines, United States

²UnityPoint Clinic Multi-Specialty-Infectious Disease, UnityPoint Health, Des Moines, United States

Cite this paper

Corey S. Ellis, Hayden L. Smith and Lisa A Veach. Adalimumab Induced Aseptic Meningitis and Focal Partial Seizures in Patient with Crohn’s Disease. American Journal of Medical Case Reports. 2019; 7(11):289-291. doi: 10.12691/AJMCR-7-11-7

Abstract

Tumor necrosis factor α inhibitors (TNFα-i) are a commonly prescribed class of medications for the treatment of inflammatory bowel disease. With the increasing use of this medication class, some uncommon adverse effects have been reported. We present a case of a young male recently prescribed adalimumab for Crohn’s disease who developed aseptic meningitis with associated focal partial seizures.

Keywords

anti-inflammatory agents/adverse effects, crohn disease/drug therapy, adalimumab, meningitis, aseptic/chemically induced, meningitis, aseptic/drug therapy

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Terdiman, J.P., Gruss, C.B., Heidelbaugh, J.J., Sultan, S., Falck-Ytter, Y.T. “American Gastroenterological Association Institute Guideline on the use of thiopurines, methotrexate and anti-TNF-alpha biologic drugs for induction and maintenance of remission in inflammatory Crohn’s disease.” Gastroenterology, 145: 1459-63. Dec.2013.
[2]	Marotte, H., Charrin, J.E., Miossec, P. “Infliximab-induced aseptic meningitis.” Lancet, 358: 1784. Nov. 2001.
[3]	Wang, D.Y., Chong, W.S., Pan, J.Y., Heng, Y.K. “First case report of aseptic meningitis induced by adalimumab administered for treatment of chronic plaque psoriasis.” J Investig Allergol Clin Immunol, 27: 183-5. Feb. 2017.
[4]	Hamilton, A.J., Gutowski, N.J. “Aseptic meningitis in a patient receiving treatment with anti-tumour necrosis factor alpha.” J Neurol, 258: 1174-5. Dec.2011.
[5]	Matsuura-Otsuki, Y., Hanafusa, T., Yokozeki, H., Watanabe, K. “Infliximab-induced aseptic meningitis during the treatment of psoriatic arthritis.” Case Rep Dermatol, 9: 26-9. May2017.
[6]	Shah, R., Shah, M., Bansal, N., Manocha, D. “Infliximab-induced aseptic meningitis.” Am J Emerg Med, 32: 1560. e3-4. 2014.
[7]	Hegde, N., Gayomali, C., Rich, M.W. “Infliximab-induced Headache and Infliximab-induced meningitis: Two ends of the same spectrum?” South Med J., 98: 564-6. Oct.2005.
[8]	Quispel, R., van der Worp, H.B., Pruissen, M., Schipper, M.E., Oldenburg, B. “Fatal aseptic meningoencephalitis following infliximab treatment for inflammatory bowel disease.” Gut, 55: 1056. 2006.
[9]	López Méndez, P., Martín Santana, I., del Pino Reyes Yánez, M., Ruano Hernandez, A., Hernandez Beriain, J.A., Hervas Garcia, M. “Meningeal and Guillain–Barrè syndrome in a patient with rheumatoid arthritis receiving adalimumab therapy.” Reumatol Clín, 7: 401-3. 2011.
[10]	Honda, Y., Otsuka, A., Egawa, G., Inoue, Y., Kuzuya, A., Takahashi, R., Miyachi, Y., Kabashima, K. “Multiple neurological abnormalities, including pontine hemorrhage, multiple sclerosis and aseptic meningitis, during anti-TNF-α therapy in psoriatic arthritis.” Eur J Dermatol, 25: 487-8. 2015.
[11]	Simsek, I., Erdem, H., Pay, S., Sobaci, G., Dinc, A. “Optic neuritis occurring with anti-tumour necrosis factor α therapy. Ann Rheum Dis, 66: 1255-8. 2007.
[12]	Chung, J.H., Van Stavern, G.P., Frohman, L.P., Turbin, R.E. “Adalimumab-associated optic neuritis.” J Neurol Sci, 244: 133-6. 2006.
[13]	Sillero Sánchez, M., García Domínguez, G., Asencio Marchante, J.J. “Demyelinating encephalomyelitis associated with treatment with adalimumab.” Neurología (English Edition), 25: 136-8. 2010.
[14]	Makol, A., Grover, M. “Adalimumab induced mononeuritis multiplex in a patient with refractory rheumatoid arthritis: A case report.” Cases J, 1: 287. 2008.
[15]	Manthey, C., Lohse, A.W., Pace, A. “Case report of aseptic meningitis in a patient with Crohnʼs disease under infliximab therapy.” Inflamm Bowel Dis, 17: E10. Feb.2011.