Case Report

Clinical Rheumatology

, Volume 29, Issue 10, pp 1201-1204

First online:

Cerebral tuberculoma in a patient receiving anti-TNF alpha (adalimumab) treatment

  • Karen LynchAffiliated withDepartment of Neuropathology, Beaumont HospitalDepartment of Neurology Tufts University, St Elizabeth’s Medical Center Email author 
  • , Michael FarrellAffiliated withDepartment of Neuropathology, Beaumont Hospital

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Abstract

We report a case of a cerebral tuberculoma in a 60-year-old woman with rheumatoid arthritis while receiving the anti-tumor necrosis factor alpha monoclonal antibody, adalimumab (Humira), for active disease. MR brain imaging for dyspraxia revealed a left parietal ring-enhancing lesion, which on resection was shown to be a necrotizing granuloma. There were no associated pulmonary lesions, and the patient was systemically well. Sputum and urine cultures were negative for tuberculosis. The patient was treated with anti-tuberculous medications and made an excellent recovery. We consider this to be the first documented case of tuberculosis involving the central nervous system occurring in the setting of adalimumab treatment.

Keywords

Adalimumab Anti-TNF Cerebral Rheumatoid arthritis. Tuberculoma