AI Article Synopsis
- A 36-year-old woman with relapsing remitting multiple sclerosis developed right-sided spasms, seizures, and neuropsychiatric issues 10 months after starting alemtuzumab treatment.
- Subsequent MRI showed multiple areas of hyperintensity, but tests for conditions like PML and vasculitis came back negative.
- A brain biopsy indicated eosinophilic vasculitis, leading to successful treatment with cyclophosphamide and highlighting the need for awareness of such complications post-alemtuzumab, even when standard tests are negative.
Article Abstract
A 36-year-old woman with relapsing remitting multiple sclerosis (MS) presented with right-sided spasms, focal seizures and neuropsychiatric symptoms 10 months after her first course of alemtuzumab. Magnetic resonance imaging (MRI) brain imaging revealed multiple foci of T2 hyperintensity. Subsequent blood and cerebrospinal fluid (CSF) testing for progressive multifocal leukoencephalopathy (PML), vasculitis and infective causes was negative. A brain biopsy was performed, revealing a prominent perivascular inflammatory infiltrate with multiple immune cells including eosinophils, suggesting eosinophilic vasculitis. The patient was treated successfully with cyclophosphamide. The potential sequelae of alemtuzumab treatment are discussed; this treatable complication should be considered when tests for JC virus are negative.
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| http://dx.doi.org/10.1177/1352458519898113 | DOI Listing |
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