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Hemophagocytic Lymphohistiocytosis in 2 Patients with Multiple Sclerosis Treated With Alemtuzumab

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Peer-reviewed

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Article

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Authors

Saarela, Mika 
Senthil, Keerthi 
Jones, JL 
Tienari, Pentti 
Soilu-hanninen, Merja 

Abstract

Alemtuzumab is a highly effective treatment of relapsing-remitting multiple sclerosis (RRMS) with a complex safety profile, including secondary autoimmunity in 40% of patients [1]. We report two cases of hemophagocytic lymphohistiocytosis (HLH) in patients after alemtuzumab treatment of RRMS. This hyperinflammatory syndrome consists of fever, lymphadenopathy, pancytopenia, liver abnormalities, hyperferritinemia, raised soluble interleukin 2 (IL2) receptor and hemophagocytosis; it may be secondary to malignancies, autoimmune diseases, or infections [2]. Table 1 summarizes the diagnostic criteria for secondary HLH.

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Journal Title

Neurology

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Journal ISSN

Volume Title

90

Publisher

Wolters Kluwer Health
Sponsorship
Wellcome Trust (105924/Z/14/Z)
Wellcome Trust (105924/Z/14/A)
Wellcome Trust (105924/Z/14/Z)