Thrombotic Thrombocytopenic Purpura-Hemolytic Uremic Syndrome in Relapsing-Remitting Multiple Sclerosis Patients on High-Dose Interferon β

Mult Scler. 2014 Nov;20(13):1783-7. doi: 10.1177/1352458514523692. Epub 2014 Feb 17.

Abstract

Three women aged 34-47 years old, on high dose interferon beta-1a for relapsing-remitting multiple sclerosis, were hospitalized between 2009-2012 for thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Patients sought medical attention for neurological symptoms including cephalalgia, blurred vision, confusion, focal deficits and seizures. All patients presented thrombocytopenia, hemolytic anemia and arterial hypertension. Despite plasma exchanges, corticosteroids and anti-CD20 treatments, all patients progressed towards severe renal insufficiency and one patient died of hemorrhagic shock. In this report we identify a rare but morbid complication of interferon beta-1a treatment associated with female gender, Caucasian background and low body mass index.

Keywords: Multiple sclerosis; hemolytic anemia; interferon beta; renal insufficiency; thrombocytopenia; thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adjuvants, Immunologic / adverse effects*
  • Adult
  • Female
  • Hemolytic-Uremic Syndrome / chemically induced*
  • Humans
  • Interferon beta-1a
  • Interferon-beta / adverse effects*
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Purpura, Thrombotic Thrombocytopenic / chemically induced*

Substances

  • Adjuvants, Immunologic
  • Interferon-beta
  • Interferon beta-1a