Alopecia Universalis in a Multiple Sclerosis Patient After Switching From Rituximab to Ocrelizumab: A Case Report

Int J Rheum Dis. 2024 Dec;27(12):e70028. doi: 10.1111/1756-185X.70028.

Abstract

Ocrelizumab is a humanized monoclonal antibody, which acts as an anti-CD20 antibody. It is used as a treatment of both relapsing-remitting multiple sclerosis (RRMS) and Progressive types. The aim of this study is to report the first patient with alopecia universalis after switching from rituximab to ocrelizumab. A 37-year-old woman with a history of SPMS, diagnosed 8 years ago, used to be treated with rituximab. Her drug was switched to ocrelizumab from 6 months ago. She presented with patchy scalp hair loss a day after receiving the second dose of ocrelizumab. Her hair loss rapidly progressed in 3-4 days to total body hair loss in a patchy pattern. Ocrelizumab may be responsible for autoimmune reactions such as alopecia universalis in immunocompromised patients.

Keywords: alopecia areata; alopecia universalis; multiple sclerosis; ocrelizumab; rituximab.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Alopecia* / chemically induced
  • Alopecia* / diagnosis
  • Alopecia* / drug therapy
  • Antibodies, Monoclonal, Humanized* / adverse effects
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Drug Substitution*
  • Female
  • Humans
  • Immunocompromised Host
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use
  • Multiple Sclerosis, Chronic Progressive / diagnosis
  • Multiple Sclerosis, Chronic Progressive / drug therapy
  • Multiple Sclerosis, Chronic Progressive / immunology
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Rituximab* / adverse effects
  • Rituximab* / therapeutic use
  • Treatment Outcome

Substances

  • Rituximab
  • Antibodies, Monoclonal, Humanized
  • ocrelizumab
  • Immunologic Factors

Supplementary concepts

  • Alopecia universalis