Autoimmune encephalitis and CSF anti-glur3 antibodies in an MS patient after alemtuzumab treatment

Maria Chiara Buscarinu, Arianna Fornasiero, Giulia Pellicciari, Roberta Reniè, Anna Chiara Landi, Alessandro Bozzao, Cristina Cappelletti, Pia Bernasconi, Giovanni Ristori, Marco Salvetti

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article number299
JournalBrain Sciences
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Alemtuzumab
  • Antibodies against glur3 peptide
  • Autoimmune diseases
  • Immune thrombocytopenic purpura;autoimmune encephalitis
  • Multiple sclerosis

ASJC Scopus subject areas

  • Neuroscience(all)

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