ReviewClinical rheumatology2013
Severe Guillain-Barré syndrome in a patient receiving anti-TNF therapy. Consequence or coincidence. A case-based review.
Review in Clinical rheumatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Qualitative evaluation of pharmacological strategy for connective tissue diseases with Guillain-Barré syndrome: a systematic review.Frontiers in immunology · 2026Pooled it
- Peripheral neuropathies associated with anti-tnf-α treatments: a systematic review and proposed recommendations.Journal of neurology · 2025Pooled it
- Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain-Barré syndrome.The Cochrane database of systematic reviews · 2016Pooled it
- A case report: Guillain-Barré syndrome probably associated with TNF inhibitor in Blau syndrome.BMC pediatrics · 2026Article
- Acute Motor Conduction Block Neuropathy After Initiation of Omalizumab: Case Report and Literature Review for Possible Causality.eNeurologicalSci · 2024Article
- Neurological Side Effects of TNF-α Inhibitors Revisited: A Review of Case Reports.Medicina (Kaunas, Lithuania) · 2024Review
- Article
- Pharmacovigilance of Biopharmaceuticals in Rheumatic Diseases, Adverse Events, Evolution, and Perspective: An Overview.Biomedicines · 2020Review
- Contribution of Causality Assessment for an Automated Detection of Safety Signals: An Example Using the French Pharmacovigilance Database.Drug safety · 2020Article
- Effects of omalizumab therapy on peripheral nerve functions: short observational study.Postepy dermatologii i alergologii · 2019Article
- First case of demyelinating polyneuropathy probably related to treatment with golimumab.European journal of rheumatology · 2018Article
- Neurological Complications of Therapeutic Monoclonal Antibodies: Trends from Oncology to Rheumatology.Current neurology and neuroscience reports · 2017Review
- Guillain-Barré syndrome in association with antitumour necrosis factor therapy: a case of mistaken identity.BMJ case reports · 2017Article
- Article
- Guillain-Barré syndrome in a patient on adalimumab for the treatment of psoriasis.Anais brasileiros de dermatologia · 2017Article
- Adverse reactions to biologic agents and their medical management.Nature reviews. Rheumatology · 2014Review
- Non-length-dependent and length-dependent small-fiber neuropathies associated with tumor necrosis factor (TNF)-inhibitor therapy in patients with rheumatoid arthritis: expanding the spectrum of neurological disease associated with TNF-inhibitors.Seminars in arthritis and rheumatism · 2014Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The adverse effects of anti-tumour necrosis factor alpha (TNFα) drugs include an increase in the risk of infections, congestive heart failure, lupus-like syndrome, and the onset or worsening of various demyelinating diseases such as, multiple sclerosis, optic neuritis, and Guillain-Barrè syndrome (GBS), among others. We describe the case of a patient who developed GBS while she was on treatment with adalimumab. A 50-year-old woman with rheumatoid arthritis (RA) was admitted to the hospital due to progressive severe bilateral symmetric weakness of the legs, which quickly extended to the upper limbs and to the respiratory muscles. Adalimumab was started 13 months before. GBS was diagnosed and the anti-TNFα therapy discontinued. The serological test for Campylobacter jejuni was positive. She required invasive mechanical ventilatory support for 9 months. Twelve months later, the patient was using a wheelchair following a rehabilitation programme, and at 24 months she was walking a few steps with assistive devices. The relevant literature on the relationship between GBS and anti-TNFα is reviewed. Twenty three cases of GBS occurring during anti-TNFα therapy have been reported so far in the literature. In several cases, there was no clear temporal association, more than half had a possible previous infection, and in two cases the drug was reintroduced without recurrence of GBS. Our case, which is best explained by C. jejuni infection, as well as some of the cases described are probably not a direct result of anti-TNFα treatment, but an accidental coincidence. We also discuss the potential therapeutic options after anti-TNFα discontinuation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.