Infliximab-induced aseptic meningitis

Kashyap, A S; Kashyap, Surekha

doi:10.1016/s0140-6736(02)08241-7

Cited by 18 publications

(3 citation statements)

References 2 publications

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“…Aseptic meningitis can be induced by several drugs including nonsteroidal antiinflammatory drugs, antimicrobials, and infliximab [ 1 2 3 ]. The 2 proposed mechanisms of drug-induced aseptic meningitis are direct irritation of the meninges owing to intrathecal administration of the drug and immunological hypersensitivity to the drug [ 1 ].…”

Section: Case Presentationmentioning

confidence: 99%

Infliximab-Induced Aseptic Meningitis during the Treatment of Psoriatic Arthritis

Matsuura-Otsuki¹,

Hanafusa

Yokozeki

et al. 2017

Case Rep Dermatol

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A 42-year-old Japanese man presented with persistent headache during treatment for psoriatic arthritis (PsA) with infliximab. Treatment with infliximab was initiated 3 years before and the psoriatic skin lesions with arthritis were well controlled. However, after 21 doses of infliximab, the skin lesions and joint pain exacerbated and became intractable. Ten days after the dosage of infliximab was increased, the patient experienced headache and nausea with high fever. He had scaly, well-circumscribed erythemas on his trunk, extremities, and deformed nails. He also had swelling and pain in multiple joints. His complete blood and differential leukocyte counts were normal. The level of C-reactive protein was 16.66 mg/dL, whereas anti-infliximab antibodies were absent. Nuchal rigidity was absent and there were no abnormal neurological findings; however, jolt test results were positive. Results from magnetic resonance imaging were normal, whereas those from cerebrospinal fluid (CSF) examination were almost normal. The CSF contained mononuclear cells and was negative for bacteriological cultures, India ink staining, and polymerase chain reaction amplification of herpesvirus group DNA. Headache and nausea improved 2 months after infliximab was discontinued. The patient failed to respond to infliximab treatment for PsA, and we diagnosed infliximab-induced aseptic meningitis. Infliximab was discontinued and treatment with ustekinumab and methotrexate was initiated. Thereafter, the psoriatic skin lesion and joint pain gradually improved. Infliximab-induced aseptic meningitis may be a differential diagnosis when symptoms of meningitis develop during infliximab administration.

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Section: Case Presentationmentioning

confidence: 99%

Infliximab-Induced Aseptic Meningitis during the Treatment of Psoriatic Arthritis

Matsuura-Otsuki¹,

Hanafusa

Yokozeki

et al. 2017

Case Rep Dermatol

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“…Other adverse reactions, affecting the central nervous system including headache have been described [8]. Several cases in the literature demonstrate the occurrence of aseptic meningitis during infliximab treatment, while others demonstrate the presence of listeria meningitis [9][10][11][12]. This case is the first in literature to our knowledge that shows the occurrence of bacterial meningitis (Streptococcus pneumoniae) in association with infliximab treatment.…”

Section: Introductionmentioning

confidence: 71%

Bacterial meningitis associated with infliximab

2006

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We report an episode of bacterial meningitis in a 45 year-old woman, who was treated with infliximab for Wegener's granulomatosis. This patient presented with the classic clinical presentation of acute meningitis: the triad of fever, neck stiffness, and an altered mental state that appeared 6 months after the infliximab initiation. A computed tomographic (CT) scan of the head showed cerebral edema and Streptococcus pneumoniae was isolated from blood and CSF cultures. Prompt diagnosis and early treatment improved the outcome of this patient.

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“…Other rare events include anaphylactic shock, 116 red man syndrome, 120 and a possible case of aseptic meningitis . 121,122 Children under the age of 20 years have been treated with infliximab, with the rate of infusion reactions similar to that in adults. 123,124 In a retrospective study where 57 children with Crohn's disease received 361 infusions, 6.6% of all infusion reactions in 13 patients were considered to be medically significant.…”

Section: Adverse Events Associated With Infliximabmentioning

confidence: 99%