Multifocal-motor-neuropathy-like disease associated with Infliximab treatment in a patient with Crohn's disease

Abstract

Multifocal motor neuropathy is an immune-mediated disorder characterized by motor-conduction block in nerve-conduction studies. It is recognized that anti-TNF-α therapies are associated with immune-mediated conditions as adverse events. We report a case of multifocal-motor-neuropathy-like disease associated with the use of Infliximab in a patient with Crohn's disease. The diagnosis was based on neurophysiological evaluation and complete screening tests. Clinical and laboratory findings were not compatible with other potential causes. There was a mild response to the IVIg treatment, and once Infliximab treatment was withdrawn, the patient made slow but substantial progress in his motor function, with partial improvement of motor conduction blocks in the last neurophysiological evaluation. We believe there is a causal relationship between anti-TNF-α treatment and the disorder in this patient. There are few well-documented reports of this association. To our knowledge, our case is the first occurring in a patient with Crohn's disease.