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Simultaneous early-onset severe autoimmune hemolytic anemia and albuminuria during alemtuzumab treatment for multiple sclerosis.
Mult Scler. 2018 05; 24(6):813-815.MS

Abstract

BACKGROUND

Alemtuzumab, approved for multiple sclerosis (MS), can cause secondary autoimmune adverse events including thyroid disorders, immune thrombocytopenia (ITP), and glomerular nephropathies. Non-ITP autoimmune cytopenias are rarely reported.

OBJECTIVE

To report a case of autoimmune hemolytic anemia (AIHA) and nephropathy in a MS patient treated with alemtuzumab.

CASE REPORT

A 34-year-old man with MS developed albuminuria and AIHA after the first and only alemtuzumab treatment, with positive Coombs' direct and indirect tests and IgG autoantibodies. Both AIHA and nephropathy resolved 1 month after treatment with steroids and intravenous immunoglobulins.

CONCLUSION

Our report adds to literature on AIHA and nephropathy after alemtuzumab treatment and suggests to add Coombs' tests to the screening panel required for alemtuzumab treatment.

Links

Publisher Full Text

Authors+Show Affiliations

di Ioia M
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy/Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
Farina D
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy/Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
di Tommaso V
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy/Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
Travaglini D
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy.
Pietrolongo E
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy/Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
Onofrj M
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy/Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
de Luca G
MS Center, Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy.

MeSH

AdultAlbuminuriaAlemtuzumabAnemia, Hemolytic, AutoimmuneHumansImmunologic FactorsMaleMultiple Sclerosis, Relapsing-Remitting

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29359617

Citation

di Ioia, Maria, et al. "Simultaneous Early-onset Severe Autoimmune Hemolytic Anemia and Albuminuria During Alemtuzumab Treatment for Multiple Sclerosis." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 24, no. 6, 2018, pp. 813-815.
di Ioia M, Farina D, di Tommaso V, et al. Simultaneous early-onset severe autoimmune hemolytic anemia and albuminuria during alemtuzumab treatment for multiple sclerosis. Mult Scler. 2018;24(6):813-815.
di Ioia, M., Farina, D., di Tommaso, V., Travaglini, D., Pietrolongo, E., Onofrj, M., & de Luca, G. (2018). Simultaneous early-onset severe autoimmune hemolytic anemia and albuminuria during alemtuzumab treatment for multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England), 24(6), 813-815. https://doi.org/10.1177/1352458517743093
di Ioia M, et al. Simultaneous Early-onset Severe Autoimmune Hemolytic Anemia and Albuminuria During Alemtuzumab Treatment for Multiple Sclerosis. Mult Scler. 2018;24(6):813-815. PubMed PMID: 29359617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simultaneous early-onset severe autoimmune hemolytic anemia and albuminuria during alemtuzumab treatment for multiple sclerosis. AU - di Ioia,Maria, AU - Farina,Deborah, AU - di Tommaso,Valeria, AU - Travaglini,Daniela, AU - Pietrolongo,Erika, AU - Onofrj,Marco, AU - de Luca,Giovanna, Y1 - 2018/01/23/ PY - 2018/1/24/pubmed PY - 2019/9/7/medline PY - 2018/1/24/entrez KW - Multiple sclerosis KW - albuminuria KW - alemtuzumab KW - autoimmune hemolytic anemia KW - glomerular nephropathy SP - 813 EP - 815 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult Scler VL - 24 IS - 6 N2 - BACKGROUND: Alemtuzumab, approved for multiple sclerosis (MS), can cause secondary autoimmune adverse events including thyroid disorders, immune thrombocytopenia (ITP), and glomerular nephropathies. Non-ITP autoimmune cytopenias are rarely reported. OBJECTIVE: To report a case of autoimmune hemolytic anemia (AIHA) and nephropathy in a MS patient treated with alemtuzumab. CASE REPORT: A 34-year-old man with MS developed albuminuria and AIHA after the first and only alemtuzumab treatment, with positive Coombs' direct and indirect tests and IgG autoantibodies. Both AIHA and nephropathy resolved 1 month after treatment with steroids and intravenous immunoglobulins. CONCLUSION: Our report adds to literature on AIHA and nephropathy after alemtuzumab treatment and suggests to add Coombs' tests to the screening panel required for alemtuzumab treatment. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/29359617/Simultaneous_early_onset_severe_autoimmune_hemolytic_anemia_and_albuminuria_during_alemtuzumab_treatment_for_multiple_sclerosis_ L2 - https://journals.sagepub.com/doi/10.1177/1352458517743093?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -