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Hemophagocytic lymphohistiocytosis in 2 patients with multiple sclerosis treated with alemtuzumab
Tekijät: Mika Saarela, Keerthi Senthil, Joanne Jones, Pentti J. Tienari, Merja Soilu-Hänninen, Laura Airas, Alasdair Coles, Jukka T. Saarinen
Kustantaja: LIPPINCOTT WILLIAMS & WILKINS
Julkaisuvuosi: 2018
Journal: Neurology
Tietokannassa oleva lehden nimi: NEUROLOGY
Lehden akronyymi: NEUROLOGY
Vuosikerta: 90
Numero: 18
Aloitussivu: 849
Lopetussivu: 851
Sivujen määrä: 3
ISSN: 0028-3878
eISSN: 1526-632X
DOI: https://doi.org/10.1212/WNL.0000000000005420
Tiivistelmä
Alemtuzumab is a highly effective treatment of relapsing-remitting multiple sclerosis (RRMS) with a complex safety profile, including secondary autoimmunity in 40% of patients.(1) We report 2 cases of hemophagocytic lymphohistiocytosis (HLH) in patients after alemtuzumab treatment of RRMS. This hyperinflammatory syndrome consists of fever, lymphadenopathy, pancytopenia, liver abnormalities, hyperferritinemia, raised soluble interleukin 2 (IL-2) receptor, and hemophagocytosis; it may be secondary to malignancies, autoimmune diseases, or infections.(2) The table summarizes the diagnostic criteria for secondary HLH.
Alemtuzumab is a highly effective treatment of relapsing-remitting multiple sclerosis (RRMS) with a complex safety profile, including secondary autoimmunity in 40% of patients.(1) We report 2 cases of hemophagocytic lymphohistiocytosis (HLH) in patients after alemtuzumab treatment of RRMS. This hyperinflammatory syndrome consists of fever, lymphadenopathy, pancytopenia, liver abnormalities, hyperferritinemia, raised soluble interleukin 2 (IL-2) receptor, and hemophagocytosis; it may be secondary to malignancies, autoimmune diseases, or infections.(2) The table summarizes the diagnostic criteria for secondary HLH.
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