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Acquired hemophilia A and other autoimmune diseases after alemtuzumab therapy for multiple sclerosis: A report of two cases.
Mult Scler Relat Disord. 2020 May 21; 44:102181.MS

Abstract

Alemtuzumab (ALZ) is an anti-CD52 monoclonal antibody used to treat recurrent remittent multiple sclerosis (RRMS). After ALZ infusion, there is a depletion of T and B cells expressing CD52, while the stem cells and innate immune cells are spared. Longitudinal studies with long periods of follow-ups have reported ALZ-associated autoimmune diseases, such as thrombocytopenic purpura and thyroiditis. We report two patients who developed autoimmune hemophilia A or acquired hemophilia (AHA) after ALZ infusion, one of whom developed severe vitiligo. To the best of our knowledge, these two cases of ALZ-associated AHA are the first two cases to be reported in Brazil, and the fourth and fifth AHA cases to be reported worldwide. AHA is a potential life-threatening disease if not diagnosed and treated in a timely manner. The development of AHA should be cited as a possible adverse event, and specific coagulation tests must be part of the official recommendations for patient follow-ups.

Authors+Show Affiliations

Universidade José do Rosário Vellano, Belo Horizonte, MG, Brazil.Academic of Medicine at Universidade José do Rosário Vellano, Belo Horizonte, MG, Brazil.Neurology Department, Santa Casa de Misericórdia Belo Horizonte, Brazil.Department of Internal Medicine, Universidade Federal de Minas Gerais. Instituto de Ensino e Pesquisa, Santa Casa de Misericórdia de Belo Horizonte, MG, Brazil.. Electronic address: ppchristo@gmail.com.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32531751

Citation

Comini-Frota, Elizabeth R., et al. "Acquired Hemophilia a and Other Autoimmune Diseases After Alemtuzumab Therapy for Multiple Sclerosis: a Report of Two Cases." Multiple Sclerosis and Related Disorders, vol. 44, 2020, p. 102181.
Comini-Frota ER, Campos APF, Neto APG, et al. Acquired hemophilia A and other autoimmune diseases after alemtuzumab therapy for multiple sclerosis: A report of two cases. Mult Scler Relat Disord. 2020;44:102181.
Comini-Frota, E. R., Campos, A. P. F., Neto, A. P. G., & Christo, P. P. (2020). Acquired hemophilia A and other autoimmune diseases after alemtuzumab therapy for multiple sclerosis: A report of two cases. Multiple Sclerosis and Related Disorders, 44, 102181. https://doi.org/10.1016/j.msard.2020.102181
Comini-Frota ER, et al. Acquired Hemophilia a and Other Autoimmune Diseases After Alemtuzumab Therapy for Multiple Sclerosis: a Report of Two Cases. Mult Scler Relat Disord. 2020 May 21;44:102181. PubMed PMID: 32531751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acquired hemophilia A and other autoimmune diseases after alemtuzumab therapy for multiple sclerosis: A report of two cases. AU - Comini-Frota,Elizabeth R, AU - Campos,Angelo Pontes Freitas, AU - Neto,Antonio Pereira Gomes, AU - Christo,Paulo Pereira, Y1 - 2020/05/21/ PY - 2019/12/17/received PY - 2020/03/15/revised PY - 2020/05/04/accepted PY - 2020/6/13/pubmed PY - 2020/6/13/medline PY - 2020/6/13/entrez KW - Acquired hemophilia A KW - Alemtuzumab KW - Autoimmune diseases KW - Multiple sclerosis KW - Vitiligo SP - 102181 EP - 102181 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 44 N2 - Alemtuzumab (ALZ) is an anti-CD52 monoclonal antibody used to treat recurrent remittent multiple sclerosis (RRMS). After ALZ infusion, there is a depletion of T and B cells expressing CD52, while the stem cells and innate immune cells are spared. Longitudinal studies with long periods of follow-ups have reported ALZ-associated autoimmune diseases, such as thrombocytopenic purpura and thyroiditis. We report two patients who developed autoimmune hemophilia A or acquired hemophilia (AHA) after ALZ infusion, one of whom developed severe vitiligo. To the best of our knowledge, these two cases of ALZ-associated AHA are the first two cases to be reported in Brazil, and the fourth and fifth AHA cases to be reported worldwide. AHA is a potential life-threatening disease if not diagnosed and treated in a timely manner. The development of AHA should be cited as a possible adverse event, and specific coagulation tests must be part of the official recommendations for patient follow-ups. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/32531751/Acquired_hemophilia_A_and_other_autoimmune_diseases_after_alemtuzumab_therapy_for_multiple_sclerosis:_A_report_of_two_cases L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(20)30257-1 DB - PRIME DP - Unbound Medicine ER -
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