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Neurology. 2013 Nov 5;81(19):1654-8. doi: 10.1212/01.wnl.0000435293.34351.11. Epub 2013 Oct 4.

Tumefactive MS lesions under fingolimod: a case report and literature review.

Author information

1
From the Department of Neurology (G.P., A.H., P.W., K.O., J.S., E.T., J.K.), Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria; the Department of Neurology (J.S.), Klinikum rechts der Isar, Technische Universit√§t M√ľnchen, Germany; and the Department of Neurology (F.F.), Medical University of Graz, Austria.

Erratum in

  • Neurology. 2014 Apr 29;82(17):1569.

Abstract

OBJECTIVE:

To report about a possible association between fingolimod treatment and tumefactive demyelinating lesions (TDL) as seen in a patient developing repeated TDL on continued fingolimod therapy.

METHODS:

We performed serial clinical and radiologic assessments and immunophenotyping of blood and CSF immune cells. We also present a literature review about recent similar cases.

RESULTS:

Clinical course and radiologic findings were consistent with diagnosis of TDL. Immune cell phenotyping showed pronounced shifts in the immune cell composition related to fingolimod treatment. In addition, we observed a subset of highly differentiated effector cells (CD45R0negCCR7neg) within the CD8+ T-cell population, which was about 2-fold enriched in the CSF compared to the peripheral blood.

CONCLUSION:

Our observations add further evidence for the development of atypical demyelinating lesions in some patients receiving fingolimod. These might be related to a treatment-associated shift in the immunopathology of specifically susceptible individuals.

[Indexed for MEDLINE]

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