{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:09:56Z","timestamp":1781150996620,"version":"3.54.1"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Tumor necrosis factor-alpha inhibitors (TNF-\u03b1i\u2019s) such as Infliximab are effective treatments for various autoimmune diseases. However, in rare instances, they have been implicated in central nervous system demyelination. Typically, this side effect is seen within the first year of medication exposure. This case reports on the rare occurrence of a central demyelinating lesion secondary to Infliximab after several years of uncomplicated use. A 39-year-old, right-handed male with a history of ulcerative colitis (UC) was being maintained on infliximab therapy for several years before presenting to the emergency room. He reported weeks of intermittent, worsening left-sided extremity paresthesia and weakness. Initial workup ruled-out a stroke, but subsequent MRI revealed a strange right-sided cortical enhancement that anatomically corresponded to the patients\u2019 complaints. Ruling out other possibilities, the patient\u2019s TNF-\u03b1i medication became a concern. Treatment with corticosteroids and suspension of the patient\u2019s infliximab enabled a swift improvement and gradual full recovery. The patient\u2019s UC medication was subsequently changed as he returned to baseline. This case demonstrates a rare complication of a commonly prescribed medication that appeared well outside the timeframe of similar other case reports, highlighting the importance of considering TNF-\u03b1i side-effects as possible contributory factors to disease states even after many years of relative stability.<\/jats:p>","DOI":"10.1177\/23247096251381189","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:07:31Z","timestamp":1759306051000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: TNF-\u03b1 Inhibitor-Associated Demyelinating Disease"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0883-2913","authenticated-orcid":false,"given":"Christopher","family":"Tuohino","sequence":"first","affiliation":[{"name":"Western University of Health Sciences, Pomona, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Cline","sequence":"additional","affiliation":[{"name":"Kaiser Permanente San Diego Medical Center, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200746080-00002"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.10.1885"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000205"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.3.457"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar4582"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2010.06.004"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.3524"},{"key":"e_1_3_3_9_2","first-page":"140","article-title":"Infliximab-associated chiasmopathy","volume":"8","author":"Farrell E","year":"2008","unstructured":"Farrell E, Sacks JG. Infliximab-associated chiasmopathy. Ochsner J. 2008;8:140-145.","journal-title":"Ochsner J"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-236041"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2862::AID-ART474>3.0.CO;2-W"},{"key":"e_1_3_3_12_2","first-page":"3784938","article-title":"Demyelinating neurological adverse events following the use of anti-TNF-\u03b1 agents: a double-edged sword","volume":"2022","author":"Gharib MH","year":"2022","unstructured":"Gharib MH, AlKahlout MA, Garcia CB, et al Demyelinating neurological adverse events following the use of anti-TNF-\u03b1 agents: a double-edged sword. Case Rep Neurol Med. 2022;2022:3784938.","journal-title":"Case Rep Neurol Med"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000155126.82171.32"},{"key":"e_1_3_3_14_2","first-page":"677","article-title":"Pathogenesis, diagnosis, and treatment of central nervous system demyelination in patients receiving TNF-\u03b1 antagonists","volume":"74","author":"St\u00fcve O","year":"2013","unstructured":"St\u00fcve O, Zamvil SS. Pathogenesis, diagnosis, and treatment of central nervous system demyelination in patients receiving TNF-\u03b1 antagonists. Ann Neurol. 2013;74:677-687.","journal-title":"Ann Neurol"},{"key":"e_1_3_3_15_2","article-title":"Demyelinating events following initiation of anti-TNF\u03b1 therapy in the British Society for Rheumatology Biologics Registry in Rheumatoid Arthritis","volume":"81","author":"Thomas TRP","year":"2021","unstructured":"Thomas TRP, Galloway J, Hyrich K, et al Demyelinating events following initiation of anti-TNF\u03b1 therapy in the British Society for Rheumatology Biologics Registry in Rheumatoid Arthritis. Neurology. 2021;81:e1284-e1294.","journal-title":"Neurology"}],"container-title":["Journal of Investigative Medicine High Impact Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096251381189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23247096251381189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096251381189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:04:47Z","timestamp":1777449887000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23247096251381189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":14,"alternative-id":["10.1177\/23247096251381189"],"URL":"https:\/\/doi.org\/10.1177\/23247096251381189","relation":{},"ISSN":["2324-7096","2324-7096"],"issn-type":[{"value":"2324-7096","type":"print"},{"value":"2324-7096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"article-number":"23247096251381189"}}