AUTHOR=Kassabian Benedetta , Facco Monica , Miscioscia Alessandro , Carraro Samuela , Rinaldi Francesca , Gallo Paolo , Puthenparampil Marco 

TITLE=Case report: Breaking CNS immuno-privilege: TNFα-inhibitor triggers aseptic meningitis in a patient with rheumatoid arthritis

JOURNAL=Frontiers in Immunology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1432360

DOI=10.3389/fimmu.2024.1432360

ISSN=1664-3224

ABSTRACT=<p>Blood-brain barrier dysfunction might be driven by peripheral inflammation. TNFα inhibitors (TNF-α<sub>i</sub>) are occasionally associated with a wide spectrum of neurological immuno-mediated disorders. However, patients with systemic autoimmune disorders, including rheumatoid arthritis (RA), might be prone to develop further organ-specific, including central nervous system (CNS), autoimmunity. Here we report the case of a patient, affected by RA and treated with etanercept, who suddenly developed focal neurological symptoms. Cerebrospinal fluid, magnetic resonance imaging (MRI), and positron emission tomography (PET)/MRI findings are reported and support the diagnosis of TNF-α<sub>i</sub> -associated aseptic meningitis.</p>