Krumbholz Markus, Pellkofer Hannah, Gold Ralf, Hoffmann Lisa Ann, Hohlfeld Reinhard, Kümpfel Tania
Institute for Clinical Neuroimmunology, Ludwig Maximilian University, Marchioninistrasse 15, 81377 Munich, Germany.
Arch Neurol. 2007 Sep;64(9):1331-3. doi: 10.1001/archneur.64.9.1331.
Natalizumab is a new therapeutic option for relapsing-remitting multiple sclerosis. As with other antibody therapies, hypersensitivity reactions have been observed. In the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) trial, infusion-related hypersensitivity reactions developed in 4% of patients, usually within 2 hours after starting the infusion.
To report a significant, delayed, serum sickness-like, type III systemic allergic reaction to natalizumab.
Case report describing clinical follow-up and the serial measurement of antinatalizumab antibodies.
A 23-year-old man with relapsing-remitting multiple sclerosis developed a fever, arthralgias, urticarial exanthema, and a swollen lower lip during several days after his second infusion of natalizumab.
The patient developed a delayed, serum sickness-like, type III systemic allergic reaction to natalizumab. Five weeks after initiation of this therapy, he tested positive for antinatalizumab antibodies and exhibited persistent antibody titers 8 and 12 weeks later. His symptoms completely resolved with a short course of oral glucocorticosteroids.
Clinicians and patients should be alert not only to immediate but also to significantly delayed substantial allergic reactions to natalizumab.
那他珠单抗是复发缓解型多发性硬化症的一种新的治疗选择。与其他抗体疗法一样，已观察到超敏反应。在复发缓解型多发性硬化症那他珠单抗安全性和有效性（AFFIRM）试验中，4%的患者出现输液相关超敏反应，通常在开始输液后2小时内。
报告一例对那他珠单抗严重的、延迟的、血清病样III型全身性过敏反应。
描述临床随访及抗那他珠单抗抗体系列检测的病例报告。
一名23岁复发缓解型多发性硬化症男性患者，在第二次输注那他珠单抗后的几天内出现发热、关节痛、荨麻疹样皮疹和下唇肿胀。
该患者对那他珠单抗发生了延迟的、血清病样III型全身性过敏反应。开始该治疗5周后，他的抗那他珠单抗抗体检测呈阳性，8周和12周后抗体滴度持续存在。经短期口服糖皮质激素治疗后，他的症状完全缓解。
临床医生和患者不仅应警惕那他珠单抗立即发生的，还应警惕显著延迟的严重过敏反应。
