{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:22Z","timestamp":1791273322958,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Adalimumab is a monoclonal antibody that targets TNF\u2010\u03b1 and is effective in treating several autoimmune disorders, including non\u2010infectious uveitis; however, it has been associated with demyelinating lesions. This study presents two cases of CNS demyelination in patients who consumed adalimumab. First, an 18\u2010year\u2010old man presented with subacute lower\u2010limb paresis over the past month. He had an 8\u2010year history of uveitis, which was treated with adalimumab. The patient was initially treated with intravenous methylprednisolone, which resulted in improvement of the symptoms; however, the patient subsequently presented with new symptoms of left lower limb paresis and right homonymous hemianopia. MRI showed periventricular lesions, including two ill\u2010defined tumefactive demyelinating lesions (TDLs) and a cervical cord lesion. Second, a 35\u2010year\u2010old woman with a six\u2010year history of recurrent inflammatory uveitis, who had been treated with adalimumab every 2\u2009weeks for the last 6 months, developed right\u2010sided paresthesia and mild weakness. MRI showed classic periventricular \u201cDawson's fingers\u201d and a short\u2010segment lesion in the cervical spinal cord. This study demonstrates the diagnostic challenges of demyelination following administration of anti\u2010TNF\u2010\u03b1 agents. Persistence or recurrence of disease activity after discontinuation of adalimumab, along with fulfillment of MS diagnostic criteria, may favor an underlying demyelinating disease rather than a monophasic drug\u2010induced process. This study emphasizes the importance of careful consideration before prescribing anti\u2010TNF\u2010\u03b1 agents, particularly in patients with risk factors for demyelinating disease.<\/jats:p>","DOI":"10.1002\/ccr3.73502","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:19:46Z","timestamp":1788941986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti\u2010\n                    <scp>TNF<\/scp>\n                    \u2010Alpha Associated Central Nervous System Demyelination. Drug\u2010Induced Demyelination or Multiple Sclerosis Trigger? A Case Series"],"prefix":"10.1002","volume":"14","author":[{"given":"Marzie","family":"Abutorabi\u2010zarchi","sequence":"first","affiliation":[{"name":"Shahid Sadoughi Hospital, Shahid Sadoughi Medical School Shahid Sadoughi University of Medical Sciences and Health Services  Yazd Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3445-9550","authenticated-orcid":false,"given":"Amin","family":"Ziyaei","sequence":"additional","affiliation":[{"name":"Student Research Committee Shahid Sadoughi University of Medical Sciences  Yazd Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davoud","family":"Ghane","sequence":"additional","affiliation":[{"name":"Shahid Sadoughi Medical School Shahid Sadoughi University of Medical Sciences  Yazd Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.2287"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22052719"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1213448"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974\u2010024\u201003193\u20106"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq031"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1423131"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0001051512.22392.a8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(25)00270\u20104"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2024.105435"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/b978\u20100\u2010444\u201053488\u20100.00035\u20103"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0264918"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417\u2010023\u201006270\u20103"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2025.2491567"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/jir.S477708"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/cdd.2014.35"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18847"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:38:11Z","timestamp":1791272291000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccr3.73502"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73502","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73502"}}