Severe cerebellitis as a manifestation of infliximab-associated overlap of neurosarcoidosis and myelin oligodendrocyte glycoprotein antibody-associated disease – case report - Report - MDSpire
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Severe cerebellitis as a manifestation of infliximab-associated overlap of neurosarcoidosis and myelin oligodendrocyte glycoprotein antibody-associated disease – case report
Clinical Report: Acute cerebellitis in a patient with infliximab-induced overlap
Overview
This case study presents a 56-year-old male with ulcerative colitis who developed acute cerebellitis associated with infliximab therapy, revealing overlapping neurosarcoidosis and MOG antibody disease. The patient showed significant neurological deficits despite normal MRI findings.
Background
Infliximab, a TNF-α inhibitor, is commonly used in autoimmune disorders but can lead to paradoxical inflammatory reactions, including neurosarcoidosis. Neurological manifestations in these patients are rare.
Data Highlights
Parameter
Findings
Cerebrospinal Fluid Lymphocytes
100 cells/µl
CSF Glucose
Reduced
CSF Lactate
Increased
CSF Protein
Elevated
Blood-Brain Barrier Disruption
Marked
Anti-MOG Antibodies
Positive in serum and CSF
Key Findings
A 56-year-old male with ulcerative colitis developed acute dysarthria and gait instability while on infliximab therapy.
Neurological examination revealed severe truncal ataxia and impaired coordination without sensory deficits.
Markers associated with sarcoidosis were elevated, and MOG antibodies were detected in both serum and CSF.
High-dose corticosteroids led to full recovery after discontinuation of infliximab.
Clinical Implications
Clinicians should be vigilant for signs of neurosarcoidosis and MOG antibody disease in patients receiving TNF-α inhibitors who present with neurological symptoms.
Conclusion
This case demonstrates the potential for overlapping autoimmune conditions in patients treated with infliximab.
