• Der Internist · Mar 2020

    Case Reports

    [Neurological symptoms in a patient on anti-TNF therapy, methotrexate and prednisolone for rheumatoid arthritis].

    • M Bach, S Schob, and C Baerwald.
    • Medizinische Klinik und Poliklinik III, Bereich Rheumatologie, Universitätsklinikum Leipzig, Liebigstraße 20, Haus 4, 04103, Leipzig, Deutschland. bach-martin@gmx.net.
    • Internist (Berl). 2020 Mar 1; 61 (3): 313-320.

    AbstractA 78-year-old woman with rheumatoid arthritis on TNF-α inhibitor, methotrexate and prednisolone presented with severe but unspecific symptoms such as leg weakness, shivering, bifrontal headache, nausea and staggering. The broad range of differential diagnoses lead to intricate and time-consuming diagnostic procedures. Serology, magnetic resonance imaging and microbiological investigations represent important steps to make the final diagnosis of cerebral toxoplasmosis. Both diagnostic approach and therapy require close cooperation of different disciplines. Therapies of rheumatoid arthritis as well as of toxoplasmosis are based on a long-term treatment and could be associated with numerous harmful side effects. Continuous monitoring and permanent adjustment of therapy regimes are therefore mandatory.

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