Adalimumab-induced sensory vasculitic neuropathy.

Nicholas Keyi Sim, Azzam Ismail, Taimour Alam, Priya Devi Shanmugarajah

BMJ case reports 2022 Jan 17

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Vasculitis and other autoimmune conditions are known complications of tumour necrosis factor alpha (TNF-α) inhibitor use. By definition, TNF-α inhibitor induced vasculitis is a secondary systemic vasculitis. However, its phenotype is varied and can present as an isolated vasculitic neuropathy. This presents a diagnostic challenge as the gold standard for diagnosis of a vasculitic neuropathy is a peripheral nerve biopsy that meets predefined histopathological criteria. Given the poor sensitivity of the peripheral nerve biopsy, it is important that clinicians take a good history and maintain a high index of suspicion, as this is a treatable iatrogenic condition. Here we present a case of adalimumab-induced sensory vasculitic neuropathy, treated according to the Peripheral Nerve Society guideline for non-systemic vasculitic neuropathy, given her disease phenotype. © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Nicholas Keyi Sim, Azzam Ismail, Taimour Alam, Priya Devi Shanmugarajah. Adalimumab-induced sensory vasculitic neuropathy. BMJ case reports. 2022 Jan 17;15(1)