Journal of Neurology

, Volume 255, Issue 9, pp 1436–1438 | Cite as

Rituximab induces clinical stabilization in a patient with fulminant multiple sclerosis not responding to natalizumab

Evidence for disease heterogeneity
  • V. I. Leussink
  • H. C. Lehmann
  • G. Meyer zu Hörste
  • H.-P. Hartung
  • O. Stüve
  • B. C. KieseierEmail author


Multiple Sclerosis Expand Disability Status Scale Natalizumab Expand Disability Status Scale Score Therapeutic Plasma Exchange 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    McFarland HF, Martin R (2007) Multiple sclerosis: a complicated picture of autoimmunity. Nat Immunol 8:913–919PubMedCrossRefGoogle Scholar
  2. 2.
    Lassmann H, Brück W, Lucchinetti CF (2007) The immunopathology of multiple sclerosis: an overview. Brain Pathol 17:210–218PubMedCrossRefGoogle Scholar
  3. 3.
    Kieseier BC, Wiendl H, Hemmer B, Hartung HP (2007) Treatment and treatment trials in multiple sclerosis. Curr Opin Neurol 20:286–293PubMedCrossRefGoogle Scholar
  4. 4.
    Polman C, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH, Phillips JT, Lublin FD, Giovannoni G, Wajgt A, Toal M, Lynn F, Panzara MA, Sandrock AW, AFFIRM Investigators (2006) A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 354:899–910PubMedCrossRefGoogle Scholar
  5. 5.
    Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue EW, Lublin FD, Weinstock-Guttman B, Wynn DR, Lynn F, Panzara MA, Sandrock AW, SENTINEL Investigators (2006) Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med 354:911–923PubMedCrossRefGoogle Scholar
  6. 6.
    Monson NL, Cravens PD, Frohman EM, Hawker K, Racke MK (2005) Effect of rituximab on the peripheral blood and cerebrospinal fluid B cells in patients with primary progressive multiple sclerosis. Arch Neurol 62:258–264PubMedCrossRefGoogle Scholar
  7. 7.
    Stüve O, Cepok S, Elias B, Saleh A, Hartung HP, Hemmer BH, Kieseier BC (2005) Clinical stabilization and effective B cell depletion in the cerebrospinal fluid and peripheral blood in a patient with fulminant relapsing remitting multiple sclerosis. Arch Neurol 62:1620–1623PubMedCrossRefGoogle Scholar
  8. 8.
    Cross AH, Stark JL, Lauber J, Ramsbottom MJ, Lyons JA (2006) Rituximab reduces B cells and T cells in cerebrospinal fluid of multiple sclerosis patients. J Neuroimmunol 180:63–70PubMedCrossRefGoogle Scholar
  9. 9.
    Hauser SL, Waubant E, Arnold DL, Vollmer T, Antel J, Fox RJ, Bar-Or A, Panzara M, Sarkar N, Agarwal S, Langer-Gould A, Smith CH for the HERMES Trial Group (2008) B-cell depletion with an anti-CD20 monoclonal antibody (rituximab) reduces disease activity in relapsing remitting multiple sclerosis: results of a placebocontrolled randomized phase II trial. N Engl J Med 358:676–688PubMedCrossRefGoogle Scholar
  10. 10.
    McFarland HF (2008) The B cell – old player, new position on the team. N Engl J Med 358:664–665PubMedCrossRefGoogle Scholar
  11. 11.
    Keegan M, König F, McClelland R, Brück W, Morales Y, Bitsch A, Panitch H, Lassmann H, Weinshenker B, Rodriguez M, Parisi J, Lucchinetti CF (2005) Relation between humoral pathological changes in multiple sclerosis and response to therapeutic plasma exchange. Lancet 366:579–582PubMedCrossRefGoogle Scholar
  12. 12.
    Stüve O, Marra CM, Bar-Or A, Niino M, Cravens PD, Cepok S, Frohman EM, Phillips JT, Arendt G, Jerome KR, Cook L, Grand‘Maison F, Hemmer B, Monson NL, Racke MK (2006) Altered CD4+/CD8+ T-cell ratios in cerebrospinal fluid of natalizumab-treated patients with multiple sclerosis. Arch Neurol 63:1383–1387PubMedCrossRefGoogle Scholar
  13. 13.
    Niino M, Bodner C, Simard ML, Alatab S, Gano D, Kim HJ, Trigueiro M, Racicot D, Guérette C, Antel JP, Fournier A, Grand‘Maison F, Bar-Or A (2006) Natalizumab effects on immune cell responses in multiple sclerosis. Ann Neurol 59:748–754PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • V. I. Leussink
    • 1
  • H. C. Lehmann
    • 1
  • G. Meyer zu Hörste
    • 1
  • H.-P. Hartung
    • 1
  • O. Stüve
    • 1
    • 2
    • 3
  • B. C. Kieseier
    • 1
    Email author
  1. 1.Dept. of NeurologyHeinrich-Heine UniversityDüsseldorfGermany
  2. 2.Neurology SectionVA North Texas Health Care System, Medical ServiceDallasUSA
  3. 3.Dept. of Neurology and Dept. of ImmunologyUniversity of Texas Southwestern Medical, Center at DallasDallasUSA

Personalised recommendations