Acute sarcoidosis in a multiple sclerosis patient after alemtuzumab treatment

Mult Scler. 2018 Nov;24(13):1776-1778. doi: 10.1177/1352458518771276. Epub 2018 Oct 11.

Abstract

Background: Understanding the long-term effect of alemtuzumab on the immune system of multiple sclerosis (MS) patients is crucial.

Objective: To report a case of acute sarcoidosis (Löfgren's syndrome) in a relapsing-remitting MS patient, 1.5 years after the second course of alemtuzumab treatment.

Case report: Sarcoidosis was confirmed dermatohistologically, radiologically, and serologically. Analysis of the lymphocyte subpopulations showed a persistent effect of alemtuzumab treatment (CD4/CD8 ratio increased, absolute lymphocyte count of CD19-positive cells increased while CD3/4/8-positive cells were decreased).

Conclusion: Our case highlights the profound effect of alemtuzumab on the immune system and its possible risk for autoimmune complications.

Keywords: Multiple sclerosis; alemtuzumab; immune system; immunotherapy; lymphocytes; sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alemtuzumab / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antigens, CD19 / drug effects
  • CD4-Positive T-Lymphocytes / drug effects
  • CD4-Positive T-Lymphocytes / immunology
  • Humans
  • Lymphocyte Count
  • Multiple Sclerosis / drug therapy*
  • Sarcoidosis / drug therapy*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antigens, CD19
  • Alemtuzumab