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In this article, the authors report their experience with infliximab treatment in four patients with refractory neurosarcoidosis and discuss a possible mechanism for the drug's action.
Although the authors do not provide a formal definition of “refractory,” their patients had severe neurological impairments, abnormal imaging findings, and persistent disease despite use of corticosteroids and other, conventional immunosuppressant agents. Over a mean follow-up of more than 20 months, the patients remained stable, and they had no serious complications of infliximab therapy.
As the authors note, tumor necrosis factor α (TNF-α) is thought to play an important role in the inflammatory process of sarcoidosis. They note other case series in which res…