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Treatment of refractory neurosarcoidosis with infliximab
  1. Ernestina Santos (ernestina.santos{at}gmail.com)
  1. Hospital Geral Santo António, Portugal
    1. Sandip Shaunak (sandip.shaunak{at}lthtr.nhs.uk)
    1. Royal Preston Hospital, United Kingdom
      1. Shelley A Renowden (shelley.renowden{at}north-bristol.swest.nhs.uk)
      1. Frenchay Hospital, United Kingdom
        1. N J Scolding (n.j.scolding{at}bristol.ac.uk)
        1. Frenchay Hospital, United Kingdom

          Abstract

          Neurological involvement in sarcoidosis is serious and often aggressive. Many patients respond to steroids, but some show a progressive course despite treatment with steroids and even more potent immunosuppressive drugs. We aimed to describe our experience in the treatment of refractory neurosarcoidosis with Infliximab; its effect on the course of the disease and side effects. We report a series of four patients with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used. A good response, with improvement or stabilization of the neurological condition was seen in all cases, without significant side effects. Infliximab is a chimeric monoclonal antibody that neutralises the biological activity of TNF-α, a cytokine thought to play an important role in the pathophysiology of sarcoidosis. Our experience using infliximab adds to growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.

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