Favorable outcome of interferon-beta associated thrombotic microangiopathy following treatment with corticosteroids, plasma exchange and rituximab: A case report

Mult Scler Relat Disord. 2016 Nov:10:63-65. doi: 10.1016/j.msard.2016.09.002. Epub 2016 Sep 6.

Abstract

Thrombotic microangiopathy (TMA) is a rare but increasingly recognized complication of interferon-beta therapy, which can be associated with serious sequelae. We report on a 53-year-old woman with a longstanding history of relapsing-remitting multiple sclerosis, who developed TMA after 15 years of high-dose treatment with subcutaneous interferon-beta-1a. The patient presented with headaches, an epileptic seizure, confusion, and arterial hypertension. Laboratory findings included thrombocytopenia and hemolytic anemia. Despite of severe clinical manifestations and pronounced laboratory abnormalities, therapy with corticosteroids, plasma exchange and rituximab was associated with a favorable outcome and return to her premorbid level of functioning.

Keywords: Hemolytic anemia; Hemolytic uremic syndrome; Interferon beta; Multiple sclerosis; Thrombocytopenia; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Brain / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Interferon-beta / adverse effects*
  • Interferon-beta / therapeutic use
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / complications
  • Multiple Sclerosis, Relapsing-Remitting / diagnostic imaging
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Plasma Exchange*
  • Rituximab / therapeutic use*
  • Thrombotic Microangiopathies / diagnostic imaging
  • Thrombotic Microangiopathies / etiology
  • Thrombotic Microangiopathies / therapy*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Immunologic Factors
  • Rituximab
  • Interferon-beta