Alemtuzumab-related thyroid disease in people with multiple sclerosis is associated with age and brainstem phenotype at disease onset.
Alemtuzumab
brainstem
multiple sclerosis
pregnancy
thyroid
Journal
Multiple sclerosis journal - experimental, translational and clinical
ISSN: 2055-2173
Titre abrégé: Mult Scler J Exp Transl Clin
Pays: United States
ID NLM: 101668877
Informations de publication
Date de publication:
Historique:
received:
09
04
2020
accepted:
22
05
2020
entrez:
3
7
2020
pubmed:
3
7
2020
medline:
3
7
2020
Statut:
epublish
Résumé
Autoimmune thyroid disease (AITD) occurs in 40%-50% of alemtuzumab-treated persons with multiple sclerosis (pwMS), most of whom will develop Graves' Disease (GD). To explore contributory factors for alemtuzumab-related AITD in pwMS. A retrospective patient chart review was performed. Sixteen out of 52 (30.8%) pwMS developed AITD. GD occurred in 56.3% ( Alemtuzumab-induced reconstitution GD may result from early and increased cross-reactivity between antigens common to the brainstem and thyroid, or presence of shared Human Leukocyte Antigen (HLA) alleles that determine brainstem and thyroid involvement. We suggest cautious use of alemtuzumab in younger (≤32 years) pwMS with early brainstem involvement, especially those actively planning pregnancy, where alternative therapies are readily available.
Sections du résumé
BACKGROUND
BACKGROUND
Autoimmune thyroid disease (AITD) occurs in 40%-50% of alemtuzumab-treated persons with multiple sclerosis (pwMS), most of whom will develop Graves' Disease (GD).
OBJECTIVE
OBJECTIVE
To explore contributory factors for alemtuzumab-related AITD in pwMS.
METHODS
METHODS
A retrospective patient chart review was performed.
RESULTS
RESULTS
Sixteen out of 52 (30.8%) pwMS developed AITD. GD occurred in 56.3% (
CONCLUSION
CONCLUSIONS
Alemtuzumab-induced reconstitution GD may result from early and increased cross-reactivity between antigens common to the brainstem and thyroid, or presence of shared Human Leukocyte Antigen (HLA) alleles that determine brainstem and thyroid involvement. We suggest cautious use of alemtuzumab in younger (≤32 years) pwMS with early brainstem involvement, especially those actively planning pregnancy, where alternative therapies are readily available.
Identifiants
pubmed: 32612846
doi: 10.1177/2055217320933928
pii: 10.1177_2055217320933928
pmc: PMC7307483
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2055217320933928Informations de copyright
© The Author(s) 2020.
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