Severe Neuropathy and Tetraparesis Induced by Adalimumab
Bibliographic record
Abstract
We report a case of severe axonal and demyelinating peripheral polyneuropathy with consecutive tetraparesis following the second application of adalimumab in a 55-year-old man with rheumatoid arthritis. The treatment provided 40 mg of adalimumab s.c. every 2 weeks. Modest muscle pain and weakness followed the first dose, but the second dose resulted in progressive tetraparesis and complete immobility. Electroneurography revealed almost complete denervation of all muscles of the upper extremities, and no motor response at the lower extremities. The finding was suggestive of severe subchronic axonal and demyelinating peripheral polyneuropathy induced by adalimumab. A comprehensive medical work out excluded the possibility of other etiology. At discharge, methylprednisolone was continued for the next 3 months. Nine months of physical rehabilitation and supportive treatment resulted in a modest recovery. Anti-TNF- α agents may induce vasculitis neuropathy at any time during treatment which must be distinguished from the neuropathy of the underlying disease. Appropriate therapy should be initiated immediately and continued long enough. doi: http://dx.doi.org/10.4021/jnr189e
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".