Auto-immune hepatitis in a patient with multiple sclerosis treated with alemtuzumab
In two large phase III clinical studies with relapsing–remitting multiple sclerosis (RR-MS) patients, alemtuzumab (ATZ) has demonstrated high efficacy on the risk of relapse, sustained accumulation of disability, and MRI endpoints . Among the side effects of ATZ, secondary organ-specific autoimmunity has been described, mainly directed towards the thyroid. We report the first case of an early autoimmune hepatitis (AIH) occurring in a MS patient after completion of two treatment cycles with ATZ.
A 25-year-old female patient was diagnosed with RR-MS in September 2011. She declined a first-line treatment proposal. During the subsequent year, she presented with four relapses and was started on monthly infusions of natalizumab in December 2012. This treatment was interrupted after 22 infusions due to JC virus seroconversion and fear of progressive multifocal leukoencephalopathy. The patient received two courses of ATZ in November 2014 and 2015 successively. She remained stable with...
This study has received no funding.
Compliance with ethical standards
Conflict of interest
Souraya ElSankari has received travel grants from Biogen, Bayer Schering, Sanofi Genzyme, Merck, and Teva. Her institution receives honoraria for consultancy and lectures from Biogen, Bayer Schering, Sanofi Genzyme, Merck, as well as research grants from Novartis Pharma, Roche and Bayer Schering. Géraldine Dahlqvist: reports no disclosures. Laurent Monino: reports no disclosures. Vincent van Pesch: has received travel grants from Biogen, Bayer Schering, Sanofi Genzyme, Merck, Teva, Novartis Pharma and Roche. His institution receives honoraria for consultancy and lectures from Biogen, Bayer Schering, Sanofi Genzyme, Merck, Roche, Teva and Novartis Pharma as well as research grants from Novartis Pharma, Roche and Bayer Schering.
All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendements.
Informed consent was obtained from the subject included in the study.