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Serum sickness (Like Reaction) in a patient treated with alemtuzumab for multiple sclerosis: A case report.
Mult Scler Relat Disord. 2018 Nov; 26:52-54.MS

Abstract

BACKGROUND

Alemtuzumab is a monoclonal antibody approved for relapsing-remitting multiple sclerosis (RRMS). The only report of Serum Sickness (SS) in a MS patient occurred during treatment with natalizumab. Non-protein drugs, such as some antibiotics, may induce "SS-like" reactions (SSLR), whose clinical and laboratory features may partially overlap with the traditional SS.

OBJECTIVE

To report a case of SS/SSLR in a RRMS patient treated with alemtuzumab.

CASE REPORT

A 42-year-old-woman with RRMS developed SS/SSLR in the first week after the first alemtuzumab treatment. Concomitant medications included trimethoprim-sulfamethoxazole at low dose. Intravenous methylprednisolone therapy led to clinical resolution and normalization of serum inflammatory markers.

CONCLUSION

SS/SSLR should be considered in patients treated with alemtuzumab developing delayed fever, rash and arthralgia and differentiated with Infusion Associated Reactions (IARs) and infections.

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Authors+Show Affiliations

Lapucci C
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy. Electronic address: lapucci.caterina@alice.it.
Gualandi F
Department of Hematology, Ospedale Policlinico San Martino IRCCS, Genoa, Italy.
Mikulska M
Division of Infectious Diseases, University of Genova (DISSAL) and Ospedale Policlinico San Martino, Genoa, Italy.
Palmeri S
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
Mancardi G
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy; Ospedale Policlinico San Martino IRCCS, Genoa, Italy; Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy.
Uccelli A
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy; Ospedale Policlinico San Martino IRCCS, Genoa, Italy; Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy.
Laroni A
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy; Ospedale Policlinico San Martino IRCCS, Genoa, Italy; Center of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy.

MeSH

AdultAlemtuzumabFemaleGlucocorticoidsHumansImmunologic FactorsMethylprednisoloneMultiple Sclerosis, Relapsing-RemittingSerum Sickness

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30223229

Citation

Lapucci, C, et al. "Serum Sickness (Like Reaction) in a Patient Treated With Alemtuzumab for Multiple Sclerosis: a Case Report." Multiple Sclerosis and Related Disorders, vol. 26, 2018, pp. 52-54.
Lapucci C, Gualandi F, Mikulska M, et al. Serum sickness (Like Reaction) in a patient treated with alemtuzumab for multiple sclerosis: A case report. Mult Scler Relat Disord. 2018;26:52-54.
Lapucci, C., Gualandi, F., Mikulska, M., Palmeri, S., Mancardi, G., Uccelli, A., & Laroni, A. (2018). Serum sickness (Like Reaction) in a patient treated with alemtuzumab for multiple sclerosis: A case report. Multiple Sclerosis and Related Disorders, 26, 52-54. https://doi.org/10.1016/j.msard.2018.09.006
Lapucci C, et al. Serum Sickness (Like Reaction) in a Patient Treated With Alemtuzumab for Multiple Sclerosis: a Case Report. Mult Scler Relat Disord. 2018;26:52-54. PubMed PMID: 30223229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum sickness (Like Reaction) in a patient treated with alemtuzumab for multiple sclerosis: A case report. AU - Lapucci,C, AU - Gualandi,F, AU - Mikulska,M, AU - Palmeri,S, AU - Mancardi,G, AU - Uccelli,A, AU - Laroni,A, Y1 - 2018/09/11/ PY - 2018/03/08/received PY - 2018/08/04/revised PY - 2018/09/10/accepted PY - 2018/9/18/pubmed PY - 2019/3/1/medline PY - 2018/9/18/entrez KW - Alemtuzumab KW - Arthralgia KW - Monoclonal antibodies KW - Multiple Sclerosis KW - Serum sickness KW - Serum sickness like reaction SP - 52 EP - 54 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 26 N2 - BACKGROUND: Alemtuzumab is a monoclonal antibody approved for relapsing-remitting multiple sclerosis (RRMS). The only report of Serum Sickness (SS) in a MS patient occurred during treatment with natalizumab. Non-protein drugs, such as some antibiotics, may induce "SS-like" reactions (SSLR), whose clinical and laboratory features may partially overlap with the traditional SS. OBJECTIVE: To report a case of SS/SSLR in a RRMS patient treated with alemtuzumab. CASE REPORT: A 42-year-old-woman with RRMS developed SS/SSLR in the first week after the first alemtuzumab treatment. Concomitant medications included trimethoprim-sulfamethoxazole at low dose. Intravenous methylprednisolone therapy led to clinical resolution and normalization of serum inflammatory markers. CONCLUSION: SS/SSLR should be considered in patients treated with alemtuzumab developing delayed fever, rash and arthralgia and differentiated with Infusion Associated Reactions (IARs) and infections. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/30223229/Serum_sickness__Like_Reaction__in_a_patient_treated_with_alemtuzumab_for_multiple_sclerosis:_A_case_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(18)30318-3 DB - PRIME DP - Unbound Medicine ER -