Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment
A 45-year-old Italian woman, affected by relapsing−remitting multiple sclerosis (RR-MS) starting from 2011, started treatment with alemtuzumab in July 2016. Nine months after the second infusion, she had an immune thrombocytopenic purpura (ITP) with complete recovery after steroid treatmen...
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MDPI AG
2019-10-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/9/11/299 |
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| author | Maria Chiara Buscarinu Arianna Fornasiero Giulia Pellicciari Roberta Reniè Anna Chiara Landi Alessandro Bozzao Cristina Cappelletti Pia Bernasconi Giovanni Ristori Marco Salvetti |
| author_facet | Maria Chiara Buscarinu Arianna Fornasiero Giulia Pellicciari Roberta Reniè Anna Chiara Landi Alessandro Bozzao Cristina Cappelletti Pia Bernasconi Giovanni Ristori Marco Salvetti |
| author_sort | Maria Chiara Buscarinu |
| collection | DOAJ |
| description | A 45-year-old Italian woman, affected by relapsing−remitting multiple sclerosis (RR-MS) starting from 2011, started treatment with alemtuzumab in July 2016. Nine months after the second infusion, she had an immune thrombocytopenic purpura (ITP) with complete recovery after steroid treatment. Three months after the ITP, the patient presented with transient aphasia, cognitive deficits, and focal epilepsy. Serial brain magnetic resonance imaging showed a pattern compatible with encephalitis. Autoantibodies to glutamate receptor 3 peptide A and B were detected in cerebrospinal fluid and serum, in the absence of any other diagnostic cues. After three courses of intravenous immunoglobulin (0.4 mg/kg/day for 5 days, 1 month apart), followed by boosters (0.4 mg/kg/day) every 4−6 weeks, her neurological status improved and is currently comparable with that preceding the encephalitis. Autoimmune complications of the central nervous system during alemtuzumab therapy are relatively rare: only one previous case of autoimmune encephalitis following alemtuzumab treatment has been reported to date. |
| first_indexed | 2024-12-12T02:17:30Z |
| format | Article |
| id | doaj.art-e2cc1da9d8c544ca971d168b1c458512 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-12-12T02:17:30Z |
| publishDate | 2019-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-e2cc1da9d8c544ca971d168b1c4585122022-12-22T00:41:46ZengMDPI AGBrain Sciences2076-34252019-10-0191129910.3390/brainsci9110299brainsci9110299Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab TreatmentMaria Chiara Buscarinu0Arianna Fornasiero1Giulia Pellicciari2Roberta Reniè3Anna Chiara Landi4Alessandro Bozzao5Cristina Cappelletti6Pia Bernasconi7Giovanni Ristori8Marco Salvetti9Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyDepartment of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyFaculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyFaculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyFaculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyDepartment of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyNeurology IV–Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyNeurology IV–Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, ItalyDepartment of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyDepartment of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, ItalyA 45-year-old Italian woman, affected by relapsing−remitting multiple sclerosis (RR-MS) starting from 2011, started treatment with alemtuzumab in July 2016. Nine months after the second infusion, she had an immune thrombocytopenic purpura (ITP) with complete recovery after steroid treatment. Three months after the ITP, the patient presented with transient aphasia, cognitive deficits, and focal epilepsy. Serial brain magnetic resonance imaging showed a pattern compatible with encephalitis. Autoantibodies to glutamate receptor 3 peptide A and B were detected in cerebrospinal fluid and serum, in the absence of any other diagnostic cues. After three courses of intravenous immunoglobulin (0.4 mg/kg/day for 5 days, 1 month apart), followed by boosters (0.4 mg/kg/day) every 4−6 weeks, her neurological status improved and is currently comparable with that preceding the encephalitis. Autoimmune complications of the central nervous system during alemtuzumab therapy are relatively rare: only one previous case of autoimmune encephalitis following alemtuzumab treatment has been reported to date.https://www.mdpi.com/2076-3425/9/11/299multiple sclerosisautoimmune diseasesimmune thrombocytopenic purpuraautoimmune encephalitisalemtuzumabantibodies against glur3 peptide |
| spellingShingle | Maria Chiara Buscarinu Arianna Fornasiero Giulia Pellicciari Roberta Reniè Anna Chiara Landi Alessandro Bozzao Cristina Cappelletti Pia Bernasconi Giovanni Ristori Marco Salvetti Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment Brain Sciences multiple sclerosis autoimmune diseases immune thrombocytopenic purpura autoimmune encephalitis alemtuzumab antibodies against glur3 peptide |
| title | Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment |
| title_full | Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment |
| title_fullStr | Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment |
| title_full_unstemmed | Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment |
| title_short | Autoimmune Encephalitis and CSF Anti-GluR3 Antibodies in an MS Patient after Alemtuzumab Treatment |
| title_sort | autoimmune encephalitis and csf anti glur3 antibodies in an ms patient after alemtuzumab treatment |
| topic | multiple sclerosis autoimmune diseases immune thrombocytopenic purpura autoimmune encephalitis alemtuzumab antibodies against glur3 peptide |
| url | https://www.mdpi.com/2076-3425/9/11/299 |
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