EFALIZUMAB-INDUCED ISOLATED CEREBRAL LUPUS-LIKE SYNDROME

Abstract

Drug-induced lupus erythematosus has been recognized as a side effect of more than 80 drugs since its first description in association with sulfadiazine in 1945.1 Novel bioengineered agents for treatment of autoimmune disorders can also induce lupus-like syndromes. This is especially described for tumor necrosis factor alpha (TNFα) antagonists.2,3 Efalizumab is an immunosuppressive recombinant humanized IgG1 kappa isotype monoclonal antibody that binds to human CD11a. It is indicated for the treatment of adult patients with chronic moderate to severe plaque type psoriasis.4 Although efalizumab was been used for treatment of refractory subacute cutaneous lupus erythematosus,5 this drug can also induce the cutaneous form of this disease.6 However, a cerebral lupus-like syndrome has not been reported in association with efalizumab. We report a 56-year-old man who was admitted to the hospital because of psychosyndrome and movement disorder. His wife reported a change of his character 2 weeks before. A few days previously he developed uncontrolled movements of all limbs, so that he could not walk alone. There was a history of a severe recalcitrant plaque type psoriasis, which was futilely treated …