Abstract
We report a case of malignant rheumatoid arthritis (MRA) with distal symmetric sensorimotor neuropathy which showed a good response to tacrolimus therapy. A 72-yr-old female, with a 7 years history of RA was admitted to our hospital because of severe polyarthralgia, numbness of the foot and high fever. After admission she showed progressive symmetrical hypesthesia to anesthesia of bilateral distal lower limb and left footdrop. The diagnosis of MRA was made and we started etanercept and steroid pulse therapy but peripheral neuropathy did not recover. Five months later, tacrolimus was added, then not only polyarthritis but also distal neuropathy begun to improve and complete remission was obtained. This case suggests tacrolimus therapy should be considered for MRA refractory to steroid and anti-tumor necrosis factor treatment.
