RT Journal Article
SR Electronic
T1 Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-219481
DO 10.1136/bcr-2017-219481
VO 2017
A1 Patwala, Kurvi
A1 Crump, Nicholas
A1 De Cruz, Peter
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-219481.abstract
AB Guillain-Barré syndrome (GBS) is an immune-mediated disease characterised by evolving ascending limb weakness, sensory loss and areflexia. Two-thirds of GBS cases are associated with preceding infection. However, GBS has also been described in association with antitumour necrosis factor (TNF) therapies including infliximab and adalimumab for chronic inflammatory disorders such as rheumatoid arthritis, ankylosing spondylitis and inflammatory bowel disease. We present the case of a patient who developed GBS while undergoing treatment with adalimumab in combination with azathioprine for severe fistulising Crohn’s disease, and review the literature on neurological adverse events that occur in association with anti-TNF therapy. We also propose an approach to the optimal management of patients who develop debilitating neurological sequelae in the setting of anti-TNF therapy.