Extensive Multiple Sclerosis Reactivation after Switching from Fingolimod to Rituximab
Joint Authors
Holmøy, Trygve
Torkildsen, Øivind
Zarnovicky, Svetozar
Source
Case Reports in Neurological Medicine
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-07-19
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
During treatment with fingolimod, B cells are redistributed from blood to secondary lymphoid organs, where they are protected from the effect of anti-CD20 and other cell-depleting therapies.
We describe a multiple sclerosis patient who had almost complete depletion of B cells in blood during and shortly after treatment with fingolimod.
He developed severe disease activity resembling immune reconstitution syndrome after switching from fingolimod to rituximab, with first dose being six weeks after fingolimod cessation.
Following recommendations from the Swedish MS Association, rituximab treatment was started as one single dose of 1000 mg.
In patients treated with fingolimod, pathogenic B cells may still be sequestered in secondary lymph nodes if this dose is given early.
To deplete such B cells as they egress from the lymph nodes, we propose that a second dose of rituximab a few weeks after the first dose should be considered.
American Psychological Association (APA)
Holmøy, Trygve& Torkildsen, Øivind& Zarnovicky, Svetozar. 2018. Extensive Multiple Sclerosis Reactivation after Switching from Fingolimod to Rituximab. Case Reports in Neurological Medicine،Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1145418
Modern Language Association (MLA)
Holmøy, Trygve…[et al.]. Extensive Multiple Sclerosis Reactivation after Switching from Fingolimod to Rituximab. Case Reports in Neurological Medicine No. 2018 (2018), pp.1-3.
https://search.emarefa.net/detail/BIM-1145418
American Medical Association (AMA)
Holmøy, Trygve& Torkildsen, Øivind& Zarnovicky, Svetozar. Extensive Multiple Sclerosis Reactivation after Switching from Fingolimod to Rituximab. Case Reports in Neurological Medicine. 2018. Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1145418
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145418