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Treatment of refractory neurosarcoidosis with Infliximab
  1. Ernestina Santos1,
  2. Sandip Shaunak2,
  3. Shelley Renowden3,
  4. Neil J Scolding4
  1. 1Neurology Department, Hospital Geral Santo António, Porto, Portugal
  2. 2Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, UK
  3. 3Neuroradiology Department, Frenchay Hospital, Bristol, UK
  4. 4Neurology Department, Institute of Clinical Neurosciences, Frenchay Hospital, Bristol, UK
  1. Correspondence to Professor N J Scolding, Neurology Department, Institute of Clinical Neurosciences, Frenchay Hospital, Bristol BS16 1LE, UK; n.j.scolding{at}bristol.ac.uk

Abstract

Background 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.

Objective The aim of this study was to describe our experience in the treatment of refractory neurosarcoidosis with Infliximab—its effect on the course of the disease and side effects.

Methods A series of four patients are reported with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used.

Results A good response, with improvement or stabilisation 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 tumour necrosis factor α, a cytokine thought to play an important role in the pathophysiology of sarcoidosis.

Conclusion Our experience using Infliximab adds to the growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.