Alemtuzumab-induced simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy, and stroke: A case report

Alnahdi, Muhannad A; Aljarba, Sultan Ibrahim; Malik, Yaser M. Al

doi:10.1016/j.msard.2020.102141

Cited by 11 publications

(7 citation statements)

References 11 publications

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“…Fifty-three case reports and 10 case series were evaluated using the risk of bias assessment tool. Regarding case reports, 8 studies ( 33 , 37 , 42 , 58 , 67 , 70 , 75 , 81 ) had the highest methodological quality, together with 3 other studies ( 30 , 43 , 56 ) that similarly reported high quality information. For the remaining case reports, the risk of bias evaluation revealed mainly the lack of data on patients’ race and patients’ history presented as timeline.…”

Section: Resultsmentioning

confidence: 99%

Disease-modifying therapies and hematological disorders: a systematic review of case reports and case series

Scavone,

Liguori,

Adungba

et al. 2024

Front. Neurol.

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IntroductionDisease modifying therapies (DMTs) used to treat multiple sclerosis (MS) can be associated to the occurrence of hematological disorders. This systematic review aims to provide an overview of these events occurring in real-life conditions, by describing case reports and series published in the literature.MethodsA literature search of all publications up to January 5th 2024 on the Medline and Embase databases was carried out. The results were presented both in the text and in tables.ResultsSixty-seven case reports/series were included in this review, of which more than half related to alemtuzumab, natalizumab and ocrelizumab. The publication date of included studies ranged from 2006 to 2024. The majority of case reports and series described the occurrence of late-onset hematological disorders (events that occurred more than 30 days after the first DMT administration), mainly represented by case of neutropenia, autoimmune hemolytic anemia and immune thrombocytopenia. All cases reported a favorable outcome, apart one case report that described a fatal case. Among included cases, 4 articles, all related to natalizumab, described the occurrence of myeloid disorders in 13 newborns from mother receiving the DMT.DiscussionConsidering the limitations identified in the majority of included studies, further ad hoc studies are strongly needed to better evaluate the hematological disorders of DMTs. Meantime, the strict monitoring of treated patients for the occurrence of these toxicities should be highly recommended.

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Section: Resultsmentioning

confidence: 99%

Disease-modifying therapies and hematological disorders: a systematic review of case reports and case series

Scavone,

Liguori,

Adungba

et al. 2024

Front. Neurol.

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“…The objective of this investigation was to ascertain the factors that contribute to the hematological irregularities commonly observed in association with these therapies. Several reports have surfaced regarding the incidence of stroke and suboptimal neurological outcomes among patients diagnosed with MS who have undergone alemtuzumab therapy for a minimum of two doses at least 66,67 . They were perhaps linked to hypertension, hence MS patients on alemtuzumab must have frequent arterial pressure monitoring, with special attention paid to increases in systolic BP of more than 20 mmHg, or 20%.…”

Section: Discussionmentioning

confidence: 99%

Association of multiple sclerosis with stroke: A comprehensive review

Marsool,

Prajjwal,

John

et al. 2024

Health Science Reports

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BackgroundMultiple sclerosis (MS) is a chronic immune‐mediated disorder characterized by the degradation of the myelin sheath in the central nervous system. Research indicates that individuals with MS exhibit a higher susceptibility to stroke compared to the general population. This association is rooted in shared underlying mechanisms, specifically involving neuroinflammatory processes.MethodologyWe performed an extensive search on PubMed, MEDLINE, Embase, Scopus, and Google Scholar using specific terms. The search terms included variations of “multiple sclerosis,” “stroke,” “cerebrovascular disease,” “vascular risk factors,” “disease‐modifying therapies,” and “neuroinflammation.” The search was limited to articles published from January 1, 2000, up to 31 May, 2023.Results and DiscussionStroke, a global health burden characterized by significant mortality and adult disability, underscores the critical importance of understanding the link between MS and stroke. Despite a growing body of research establishing an elevated risk of stroke in MS patients, notable information gaps persist. Limited prospective multicenter studies on stroke incidence in MS patients contribute to an incomplete understanding of the precise relationship between these two conditions.ConclusionIn conclusion, this review underscores the critical need for a thorough understanding of the complex relationship between MS and stroke. The identified risk factors and the influence of MS DMTs on stroke risk necessitate further investigation to inform evidence‐based preventive and therapeutic strategies. Bridging the existing information gaps through prospective multicenter studies is imperative for a comprehensive understanding of this association. The development of targeted diagnostic and therapeutic approaches for acute stroke risk in MS patients is paramount to mitigate the impact of these debilitating conditions. Ultimately, this review serves as a foundation for future efforts to enhance preventative measures and therapeutic interventions, thereby improving the overall quality of life for individuals with MS susceptible to strokes.

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“…According to existing literature, treatment with subcutaneous interferon beta 1a (IFN-β1a) does not increase the risk of stroke in patients with MS. 31 Muhannad et al reported a case of alemtuzumab-induced simultaneous onset of autoimmune hemolytic anemia, alveolar hemorrhage, nephropathy, and stroke in a 52-year-old man that occurred 8 months after treatment initiation. 32 On the other hand, dimethyl fumarate (DMF) is hypothesized to provide clinical benefit to MS patients in case of ischemic stroke. 33 …”

Section: Discussionmentioning

confidence: 99%

Coexistence of neurofibromatosis type I, multiple sclerosis, and ischemic stroke: A case report and literature review

Perucca,

Morello,

Robecchi Majnardi

2024

SAGE Open Medical Case Reports

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Neurofibromatosis type I and multiple sclerosis, when considered separately, are associated with a higher risk of cerebrovascular accident. The coexistence of neurofibromatosis type I and multiple sclerosis may lead to a further increase in cerebrovascular risk; however, this has not been reported in the literature. We report the case of a 37-year-old woman affected by both neurofibromatosis type I and multiple sclerosis: she was referred to our rehabilitation department because of a recent event of ischemic stroke. Moreover, we provide a comprehensive and updated review of all published cases reporting the coexistence of neurofibromatosis type I and multiple sclerosis to gather information regarding their association with cerebrovascular accidents.

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Alemtuzumab-induced simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy, and stroke: A case report

Cited by 11 publications

References 11 publications

Disease-modifying therapies and hematological disorders: a systematic review of case reports and case series

Disease-modifying therapies and hematological disorders: a systematic review of case reports and case series

Association of multiple sclerosis with stroke: A comprehensive review

Coexistence of neurofibromatosis type I, multiple sclerosis, and ischemic stroke: A case report and literature review

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