Table 1.
Cases | 1 | 2 | 3 | 4 |
---|---|---|---|---|
Gender | Male | Male | Female | Female |
Type of rheumatic disease | PA | AS | PA | AS |
Duration of anti-TNFa treatment | 8 months | 3 years | 4 years | 6 years |
Family history | PA (mother), Ps (aunts) | MS (father), Ps (sister) | — | — |
Anti-TNFa | Etanercept | Adalimumab | Etanercept | Etanercept |
Age at onset of symptoms | 17 years | 30 years | 46 years | 57 years |
Symptoms | Dysesthesias of left lower limb, T4 level | Right unilateral tinnitus, urinary urgency | Left parietotemporal headache, paresthesias of the left side of the face and head, urinary urgency, diminished libido | Peripheral paresis of right facial nerve, dysarthria, mild surface dysgraphia. |
CNS MRI | Hyperintensities (1 Gd+ lesion at C3 level) | Hyperintensities (>5 lesions showed Gd+) | Hyperintensities (no Gd+ lesions) | Hyperintensities (1 Gd+ lesion at left parietal lobe and 1 at C4-C5 level) |
OB | Yes | Yes | Yes | Yes |
Evolution | MS | MS | Monophasic demyelinating event | MS |
PA: psoriatic arthritis, AS: ankylosing spondylitis, Ps: psoriasis, anti-TNFa: tumor necrosis factor alpha antagonist, MRI: magnetic resonance imaging; OB: oligoclonal bands, MS: multiple sclerosis, and Gd+: gadolinium enhancement.