| Presentation preference | Oral presentation |
| Title | Adalimumab induced multiple sclerosis-like findings in pediatric patient with uveitis |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report a rare case of induced multiple sclerosis-like findings in pediatric patient with uveitis after treatment with adalimumab and to highlight the importance of early recognition of this adverse effect. |
| Methods | A case report |
| Results | A 15-year-old HLA B51 and HLA DR15 positive patient with no systemic manifestations was treated with methotrexate and adalimumab for noninfectious chronic bilateral intermediate uveitis with poor control of disease activity and multiple ocular complications. Three years after starting adalimumab, the patient developed unilateral optic neuritis. Magnetic resonance imaging (MRI) of the brain and spinal cord revealed demyelinating lesions consistent with multiple sclerosis. Neurological workup suspected the diagnosis of adalimumab induced multiple sclerosis. Adalimumab was discontinued, and the patient was treated with pulse corticosteroid therapy with full vision recovery. Uveitis remained in remission. Follow-up MRI of the brain after six months showed marked resolution of the demyelinating lesions. The findings suggested that the demyelination was due to autoimmune encephalitis as a side effect of adalimumab, rather than sequelae of multiple sclerosis or an infectious process. |
| Conclusion | Adalimumab can induce severe demyelinating conditions in pediatric uveitis patients, especially in specific HLA positive patients. Early recognition, drug discontinuation, and prompt treatment are essential for full recovery and improved outcomes. Physicians should be cautious when using adalimumab in patients with autoimmune diseases. |
| Conflict of interest | No |
1
| Last name | BURGIC |
| Initials of first name(s) | SS |
| Department | Eye Clinic, University Clinical Center of Republic of Srpska |
| City | Banja Luka |
| Country | Bosnia and Herzegovina |
2
| Last name | Smoljanovic Skocic |
| Initials of first name(s) | S |
| Department | King Khalid Hail Hospital |
| City | Hail |
| Country | Saudi Arabia |
3
| Last name | Markic |
| Initials of first name(s) | B |
| Department | Eye Clinic, University Clinical Center of Republic of Srpska |
| City | Banja Luka |
| Country | Bosnia and Herzegovina |
4
| Last name | Mavija |
| Initials of first name(s) | M |
| Department | Eye Clinic, University Clinical Center of Republic of Srpska |
| City | Banja Luka |
| Country | Bosnia and Herzegovina |
