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Mult Scler Relat Disord. 2018 Dec 3;28:31-33. doi: 10.1016/j.msard.2018.12.004. [Epub ahead of print]

Autoimmune encephalitis following alemtuzumab treatment of multiple sclerosis.

Author information

1
Department of Neurology, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia. Electronic address: blakegiarola@gmail.com.
2
Department of Neurology, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia. Electronic address: jennifer.massey@svha.org.au.
3
Department of Radiology, St Vincent's Hospital, Sydney, NSW, Australia.
4
Department of Pathology, St Vincent's Hospital, Sydney, NSW, Australia.
5
Department of Neurology, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia.

Abstract

Secondary autoimmune disorders are a recognised complication of alemtuzumab treatment for multiple sclerosis. We report a case of autoimmune encephalitis manifesting as a polymorphic epilepsia partialis continua / status epilepticus seven months after the second course of alemtuzumab in a patient with previous autoimmune hypothyroidism and immune thrombocytopenic purpura. An MRI revealed multifocal cortical abnormalities and neuronal loss was evident on biopsy. Although testing for anti-neuronal antibodies was negative, the patient responded well to immunotherapy including plasma exchange. This is the first reported presentation of an autoimmune encephalopathy secondary to alemtuzumab therapy.

KEYWORDS:

Alemtuzumab; Encephalitis MRI; Histopathology; Multiple sclerosis

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