{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:02:50Z","timestamp":1789473770482,"version":"build-2803163510"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Infliximab, a chimeric monoclonal antibody against anti-tumor necrosis factor-\u03b1 (TNF-\u03b1), has revolutionized the management of inflammatory bowel disease. However, a recent nested case-control study showed that anti-TNF-\u03b1 therapy exposure in patients with autoimmune diseases is associated with an increased risk of inflammatory central nervous system (CNS) events. A 27-year-old man diagnosed with Crohn\u2019s disease at 17 years of age was referred to our clinic for suffering with Wernicke\u2019s aphasia and the right-hand weakness over two weeks. Nine years of treatment for Crohn\u2019s disease with infliximab anti-TNF-\u03b1 therapy was well tolerated. An initial MRI revealed diffuse leptomeningeal enhancement along the bilateral cerebral sulci without any parenchymal abnormalities. Cerebrospinal fluid (CSF) and serum N-methyl-D-aspartate receptor (NMDAR) antibody testing yielded positive results. Anti-NMDAR encephalitis was diagnosed, and the patient was treated with rituximab. A follow-up brain MRI showed new multiple cerebral lesions in the left insular cortex and subcortical white matter of the left frontal and temporal gyri. Approximately 8 months after symptom onset, the CSF and serum NMDAR antibody converted to negative. Twelve months later, the patient fully recovered from anti-NMDAR encephalitis without any neurological deficits and is currently being treated with the anti-interleukin 12\/23 agent ustekinumab for Crohn\u2019s disease. This is the first report of not only a patient with infliximab-associated anti-NMDAR encephalitis in Crohn\u2019s disease but also of an inflammatory non-demyelinating CNS event during long-term suppression of TNF-\u03b1. Our case highlights the need for clinicians to recognize the possibility of a paradoxical autoimmune response occurring with novel biological therapies.<\/jats:p>","DOI":"10.3389\/fimmu.2022.957575","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T05:44:50Z","timestamp":1667195090000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Anti-NMDAR encephalitis in Crohn\u2019s disease undergoing long-term infliximab treatment: A case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Shin Ju","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Nam","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Kyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin 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