Reactions Weekly

, Volume 1780, Issue 1, pp 135–135 | Cite as

Dimethyl fumarate/fingolimod

Hepatitis E virus infection: 4 case reports
Case report
Author Information

An event is serious (based on the ICH definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * other medically important event

In an observational case series study comprising of patients followed between January 2016 and December 2018, four patients (three women and one man) aged 24-55 years were described who developed hepatitis E virus (HEV) infection during treatment with fingolimod or dimethyl fumarate for multiple sclerosis (MS).

Patient 1: A 24-year-old woman developed HEV infection during treatment with fingolimod for MS. The woman, who had relapsing-remitting MS, was receiving treatment with glatiramer acetate. Subsequently, she was switched to oral fingolimod [dosage not stated]. However, 10 months after initiation of fingolimod therapy, laboratory investigation revealed asymptomatic elevation of liver enzymes. Serological examination demonstrated positive serology for HEV with IgM 2.1 and...


  1. Diebold M, et al. Hepatitis e virus infections in patients with MS on oral disease-modifying treatment. Neurology: Neuroimmunology and NeuroInflammation 6: No. 5, Sep 2019. Available from: URL: - SwitzerlandCrossRefGoogle Scholar

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© Springer International Publishing AG 2019

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