Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study
Abstract The therapeutic options for disease modification in relapsing-remitting multiple sclerosis (RRMS) have expanded remarkably in the last 15 years. Although intravenous immunoglobulins (IVIg) have shown some therapeutic effects in multiple sclerosis, reducing global supplies, restriction of tr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-08-01
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| Series: | Neurology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40120-020-00209-0 |
| _version_ | 1797209034158243840 |
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| author | Srishti Gupta Mohnish Suri Cris S. Constantinescu |
| author_facet | Srishti Gupta Mohnish Suri Cris S. Constantinescu |
| author_sort | Srishti Gupta |
| collection | DOAJ |
| description | Abstract The therapeutic options for disease modification in relapsing-remitting multiple sclerosis (RRMS) have expanded remarkably in the last 15 years. Although intravenous immunoglobulins (IVIg) have shown some therapeutic effects in multiple sclerosis, reducing global supplies, restriction of treatment to essential indications and availability of effective alternative treatments for MS currently exclude IVIg from being an accepted therapy for MS, other than for some exceptional considerations. We report the case of a female patient with RRMS who was diagnosed with Ehlers-Danlos syndrome (EDS) and Muir-Torre syndrome (MTS) soon after the diagnosis of active RRMS was made. The coexisting conditions precluded the use of available disease-modifying treatments. She benefited from monthly and then bi-monthly IVIg, with a single mild relapse over 10 years. Discontinuation of IVIg due to reduced availability with a brief aborted course of subcutaneous PEGylated interferon-beta was followed by significant relapses. Five months after the first ocrelizumab infusion, she developed caecal cancer requiring colectomy. Reinstitution of IVIg is contemplated. |
| first_indexed | 2024-04-24T09:48:17Z |
| format | Article |
| id | doaj.art-fd97dbf6b8b8425b81ec4dd5df2839c8 |
| institution | Directory Open Access Journal |
| issn | 2193-8253 2193-6536 |
| language | English |
| last_indexed | 2024-04-24T09:48:17Z |
| publishDate | 2020-08-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Neurology and Therapy |
| spelling | doaj.art-fd97dbf6b8b8425b81ec4dd5df2839c82024-04-14T11:33:41ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362020-08-019260561010.1007/s40120-020-00209-0Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case StudySrishti Gupta0Mohnish Suri1Cris S. Constantinescu2Department of Neurology, Queen’s Medical Centre Campus, Nottingham University Hospitals NHS TrustClinical Genetics Service, City Hospital Campus, Nottingham University Hospitals NHS TrustDepartment of Neurology, Queen’s Medical Centre Campus, Nottingham University Hospitals NHS TrustAbstract The therapeutic options for disease modification in relapsing-remitting multiple sclerosis (RRMS) have expanded remarkably in the last 15 years. Although intravenous immunoglobulins (IVIg) have shown some therapeutic effects in multiple sclerosis, reducing global supplies, restriction of treatment to essential indications and availability of effective alternative treatments for MS currently exclude IVIg from being an accepted therapy for MS, other than for some exceptional considerations. We report the case of a female patient with RRMS who was diagnosed with Ehlers-Danlos syndrome (EDS) and Muir-Torre syndrome (MTS) soon after the diagnosis of active RRMS was made. The coexisting conditions precluded the use of available disease-modifying treatments. She benefited from monthly and then bi-monthly IVIg, with a single mild relapse over 10 years. Discontinuation of IVIg due to reduced availability with a brief aborted course of subcutaneous PEGylated interferon-beta was followed by significant relapses. Five months after the first ocrelizumab infusion, she developed caecal cancer requiring colectomy. Reinstitution of IVIg is contemplated.https://doi.org/10.1007/s40120-020-00209-0Ehlers-Danlos syndromeIVIgMuir-Torre syndromeMultiple sclerosis |
| spellingShingle | Srishti Gupta Mohnish Suri Cris S. Constantinescu Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study Neurology and Therapy Ehlers-Danlos syndrome IVIg Muir-Torre syndrome Multiple sclerosis |
| title | Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study |
| title_full | Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study |
| title_fullStr | Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study |
| title_full_unstemmed | Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study |
| title_short | Maintenance Intravenous Immunoglobulin Treatment for Multiple Sclerosis Coexisting with Ehlers-Danlos Syndrome and Muir-Torre Syndrome: A Case Study |
| title_sort | maintenance intravenous immunoglobulin treatment for multiple sclerosis coexisting with ehlers danlos syndrome and muir torre syndrome a case study |
| topic | Ehlers-Danlos syndrome IVIg Muir-Torre syndrome Multiple sclerosis |
| url | https://doi.org/10.1007/s40120-020-00209-0 |
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