Erythroblast appearance associated with natalizumab

Yuya Kobayashi; Ryota Takamatsu; Shunichi Sato; Rie Watanabe; Kenichi Hoshi; Wataru Ishii; Hiroyuki Yahikozawa

doi:10.1016/j.msard.2019.01.041

Erythroblast appearance associated with natalizumab

Mult Scler Relat Disord. 2019 Apr:29:145-147. doi: 10.1016/j.msard.2019.01.041. Epub 2019 Jan 28.

Authors

Yuya Kobayashi¹, Ryota Takamatsu², Shunichi Sato², Rie Watanabe², Kenichi Hoshi², Wataru Ishii², Hiroyuki Yahikozawa²

Affiliations

¹ Department of Neurology, Nagano Red Cross Hospital, 5-22-1, Wakasato, Nagano, 380-8582, Japan. Electronic address: juriruri@shinshu-u.ac.jp.
² Department of Neurology, Nagano Red Cross Hospital, 5-22-1, Wakasato, Nagano, 380-8582, Japan.

PMID: 30711880
DOI: 10.1016/j.msard.2019.01.041

Abstract

Despite having a high rate of occurrence, erythroblast appearance in peripheral blood may not be a recognized adverse effect of natalizumab (NTZ) treatment. Additionally, the time course and cause of erythroblast appearance remain unclear. We report two cases of multiple sclerosis wherein NTZ treatment led to erythroblast appearance in peripheral blood. Erythroblasts appeared after NTZ administration; however, their counts did not increase and the administration of medication was continued. NTZ can inhibit erythroblastic island formation associated with maturing of erythroblast via VLA-4. Clinicians do not need to be afraid; however, careful observation is recommended because some patients may develop anemia.

Keywords: Anemia; Erythroblast; Multiple sclerosis; Natalizumab; VLA-4; α4β1 integrin.

Publication types

Case Reports

MeSH terms

Adult
Erythroblasts / drug effects*
Female
Humans
Immunologic Factors / adverse effects*
Male
Middle Aged
Multiple Sclerosis / drug therapy*
Natalizumab / adverse effects*
Optic Neuritis / drug therapy*
Young Adult

Substances

Immunologic Factors
Natalizumab