College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Mult Scler Relat Disord. 2020 Jun;41:102141. doi: 10.1016/j.msard.2020.102141. Epub 2020 Apr 22.
Alemtuzumab is a humanized anti-CD 52 monoclonal antibody approved as a disease-modifying therapy for active relapsing-remitting Multiple Sclerosis (MS). Alemtuzumab has been associated with several adverse effects, including infusion-associated reactions, infections, acquired autoimmune diseases, and malignancies.
We report a case of Alemtuzumab-induced simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy and stroke in a 52-year-old man that occurred 8 months after initiation of alemtuzumab. The laboratory testing was consistent with autoimmune haemolytic anaemia. Computed tomography of the chest and bronchoscopy revealed an alveolar haemorrhage. Stroke workup revealed acute infarcts in bilateral occipital territories.
This is the first case report of a simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy, and ischaemic stroke after the first alemtuzumab course in relapsing-remitting MS patient. This case highlights the potential for the co-occurrence of unexpected and potentially life-threatening complications of alemtuzumab therapy necessitating rigorous monitoring once prescribed.
阿仑单抗是一种人源化抗 CD52 单克隆抗体，被批准用于治疗活跃的复发缓解型多发性硬化症（MS）的疾病修正疗法。阿仑单抗与多种不良反应相关，包括输注相关反应、感染、获得性自身免疫性疾病和恶性肿瘤。
我们报告了一例 52 岁男性在接受阿仑单抗治疗 8 个月后发生的阿仑单抗诱导的自身免疫性溶血性贫血、肺泡出血、肾病和中风同时发作的病例。实验室检测结果符合自身免疫性溶血性贫血。胸部计算机断层扫描和支气管镜检查显示肺泡出血。中风检查显示双侧枕叶区域的急性梗死。
这是首例在复发性 MS 患者首次接受阿仑单抗治疗后同时发生自身免疫性溶血性贫血、肺泡出血、肾病和缺血性中风的病例报告。该病例强调了阿仑单抗治疗可能会同时发生意外和潜在危及生命的并发症，因此在开处方后需要进行严格监测。
