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Hemophagocytic syndrome following alemtuzumab treatment for multiple sclerosis: A case report.
Mult Scler Relat Disord. 2020 May; 40:101973.MS

Abstract

BACKGROUND

Alemtuzumab is a monoclonal antibody targeting CD-52, used for treating relapsing-remitting multiple sclerosis (RRMS).

METHODS

We present a case of a 44-year-old male with RRMS who was admitted due to fever and jaundice after starting treatment with alemtuzumab 12 months ago.

RESULTS

He was diagnosed with hemophagocytic syndrome (HS). Liver biopsy revealed images of hemophagocytosis in Kupffer cells of lobular sinusoid. Management consisted of treatment with corticosteroids.

CONCLUSION

HS is a severe condition marked by an excessive activation of the immune system that leads to a rapid and progressive multi-organ failure, so it is important to consider it in the differential diagnosis of a fever syndrome following the administration of alemtuzumab.

Links

Publisher Full Text

Authors+Show Affiliations

Romero A
Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Midaglia L
Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Salcedo MT
Department of Pathological Anatomy, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Viladomiu L
Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Guillén E
Department of Clinical Pharmacology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Bajaña I
Department of Intensive Care Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Escolà-Vergé L
Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Tintoré M
Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Montalban X
Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Division of Neurology, University of Toronto. St Michael's Hospital, Toronto, Canada.
Len O
Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Electronic address: oscar.len@vhir.org.

MeSH

AdultAlemtuzumabHumansImmunologic FactorsLymphohistiocytosis, HemophagocyticMaleMultiple Sclerosis, Relapsing-Remitting

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32028116

Citation

Romero, A, et al. "Hemophagocytic Syndrome Following Alemtuzumab Treatment for Multiple Sclerosis: a Case Report." Multiple Sclerosis and Related Disorders, vol. 40, 2020, p. 101973.
Romero A, Midaglia L, Salcedo MT, et al. Hemophagocytic syndrome following alemtuzumab treatment for multiple sclerosis: A case report. Mult Scler Relat Disord. 2020;40:101973.
Romero, A., Midaglia, L., Salcedo, M. T., Viladomiu, L., Guillén, E., Bajaña, I., Escolà-Vergé, L., Tintoré, M., Montalban, X., & Len, O. (2020). Hemophagocytic syndrome following alemtuzumab treatment for multiple sclerosis: A case report. Multiple Sclerosis and Related Disorders, 40, 101973. https://doi.org/10.1016/j.msard.2020.101973
Romero A, et al. Hemophagocytic Syndrome Following Alemtuzumab Treatment for Multiple Sclerosis: a Case Report. Mult Scler Relat Disord. 2020;40:101973. PubMed PMID: 32028116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemophagocytic syndrome following alemtuzumab treatment for multiple sclerosis: A case report. AU - Romero,A, AU - Midaglia,L, AU - Salcedo,M T, AU - Viladomiu,L, AU - Guillén,E, AU - Bajaña,I, AU - Escolà-Vergé,L, AU - Tintoré,M, AU - Montalban,X, AU - Len,O, Y1 - 2020/01/31/ PY - 2019/11/12/received PY - 2020/01/14/revised PY - 2020/01/28/accepted PY - 2020/2/7/pubmed PY - 2021/1/26/medline PY - 2020/2/7/entrez KW - Adverse effects KW - Alemtuzumab KW - Autoimmune disease KW - Corticosteroids KW - Hemophagocytic syndrome KW - Multiple sclerosis SP - 101973 EP - 101973 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 40 N2 - BACKGROUND: Alemtuzumab is a monoclonal antibody targeting CD-52, used for treating relapsing-remitting multiple sclerosis (RRMS). METHODS: We present a case of a 44-year-old male with RRMS who was admitted due to fever and jaundice after starting treatment with alemtuzumab 12 months ago. RESULTS: He was diagnosed with hemophagocytic syndrome (HS). Liver biopsy revealed images of hemophagocytosis in Kupffer cells of lobular sinusoid. Management consisted of treatment with corticosteroids. CONCLUSION: HS is a severe condition marked by an excessive activation of the immune system that leads to a rapid and progressive multi-organ failure, so it is important to consider it in the differential diagnosis of a fever syndrome following the administration of alemtuzumab. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/32028116/Hemophagocytic_syndrome_following_alemtuzumab_treatment_for_multiple_sclerosis:_A_case_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(20)30049-3 DB - PRIME DP - Unbound Medicine ER -