http://archneur.jamanetwork.com/ en-us Wed, 03 Oct 2012 00:00:00 GMT Tue, 01 Jan 2013 00:51:48 GMT Silverchair editor@archneur.jamanetwork.com webmaster@archneur.jamanetwork.com http://archneur.jamanetwork.com/article.aspx?articleID=1190811 Sat, 01 Sep 2012 00:00:00 GMT Baek W, Lee S, Kim Y, et al. <span class="paragraphSection"><div class="boxTitle">Objective</div>To describe the case of a patient who had been receiving adalimumab for rheumatoid arthritis and died of varicella-zoster virus vasculopathy with multifocal cerebral hemorrhage.<div class="boxTitle">Design</div>Case report.<div class="boxTitle">Setting</div>Hanyang University Hospital, Seoul, Republic of Korea.<div class="boxTitle">Patient</div>A 66-year-old woman with adalimumab therapy for rheumatoid arthritis followed by stuporous mental changes.<div class="boxTitle">Results</div>Magnetic resonance imaging scans showed multifocal parenchymal lesions and hemorrhage in the brainstem and supratentorial areas. Polymerase chain reaction analysis of the cerebrospinal fluid was positive for varicella-zoster virus. The patient died of multifocal vasculopathy despite intensive antiviral and antibacterial medication.<div class="boxTitle">Conclusions</div>Varicella-zoster virus multifocal vasculopathy with encephalitis may be associated with adalimumab therapy. Clinicians should be aware of the possibility of fatal varicella-zoster virus vasculopathy with encephalitis in patients undergoing adalimumab therapy for rheumatoid arthritis.</span> 69 9 1193 1196 10.1001/archneurol.2011.3741 http://archneur.jamanetwork.com/article.aspx?articleID=1190811