Autoimmune encephalitis following alemtuzumab treatment of multiple sclerosis

Mult Scler Relat Disord. 2019 Feb;28:31-33. doi: 10.1016/j.msard.2018.12.004. Epub 2018 Dec 3.

Abstract

Secondary autoimmune disorders are a recognised complication of alemtuzumab treatment for multiple sclerosis. We report a case of autoimmune encephalitis manifesting as a polymorphic epilepsia partialis continua / status epilepticus seven months after the second course of alemtuzumab in a patient with previous autoimmune hypothyroidism and immune thrombocytopenic purpura. An MRI revealed multifocal cortical abnormalities and neuronal loss was evident on biopsy. Although testing for anti-neuronal antibodies was negative, the patient responded well to immunotherapy including plasma exchange. This is the first reported presentation of an autoimmune encephalopathy secondary to alemtuzumab therapy.

Keywords: Alemtuzumab; Encephalitis MRI; Histopathology; Multiple sclerosis.

Publication types

  • Case Reports

MeSH terms

  • Alemtuzumab / adverse effects*
  • Alemtuzumab / therapeutic use
  • Brain / diagnostic imaging
  • Brain / pathology
  • Diagnosis, Differential
  • Encephalitis / diagnostic imaging
  • Encephalitis / etiology*
  • Encephalitis / pathology
  • Encephalitis / therapy
  • Female
  • Hashimoto Disease / diagnostic imaging
  • Hashimoto Disease / etiology*
  • Hashimoto Disease / pathology
  • Hashimoto Disease / therapy
  • Humans
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Immunotherapy
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / pathology
  • Multiple Sclerosis / therapy*
  • Young Adult

Substances

  • Immunologic Factors
  • Alemtuzumab

Supplementary concepts

  • Hashimoto's encephalitis