[Cyclophosphamide pulse therapy effective for childhood-onset refractory multiple sclerosis: a case report]

No To Hattatsu. 2013 Jan;45(1):49-52.
[Article in Japanese]

Abstract

We report a case of a 15-year-old girl with relapsing-remitting multiple sclerosis (MS) who received cyclophosphamide pulse therapy. At the age of 5 years, she displayed symptoms such as headache and unconsciousness after varicella infection as the first episode of MS. She had been treated with methylprednisolone pulse therapy, intravenous immunoglobulin, interferon-beta1b, and azathioprine. However, she had relapsed 12 times by the age of 15 years. At this time, she showed weakness and severe paralysis of her left leg, and even 1 month after methylprednisolone pulse therapy, she still had gait impairment and showed gadolinium-enhanced lesion on brain magnetic resonance imaging. We then started cyclophosphamide pulse therapy (600 mg/m2) once a month for 12 months combined with interferon-beta1a. She had no serious side effects and she could walk again after 4 months on cyclophosphamide treatment. She has been free from relapse for 2 years and 8 months until the present time. Although only a few studies have indicated the efficacy of cyclophosphamide pulse therapy for childhood MS, we consider careful use of cyclophosphamide could be one of the options for refractory childhood MS.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Cyclophosphamide / therapeutic use*
  • Drug Therapy, Combination / methods
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Interferon beta-1a
  • Interferon-beta / therapeutic use*
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Secondary Prevention
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Interferon-beta
  • Cyclophosphamide
  • Interferon beta-1a