Alemtuzumab‐induced immune‐mediated thrombotic thrombocytopenic purpura: A newly described drug‐related autoimmune disease

Author:

Bourdin V.1ORCID,Fossé Q.2,Lambotte O.13,Joly B.45,Coppo P.56ORCID,Anguel N.2,Labeyrie C.7

Affiliation:

1. Internal Medicine Department Hôpital Bicêtre, APHP, Université Paris Saclay Le Kremlin‐Bicêtre France

2. AP‐HP, Intensive Care Unit, Hôpital Bicêtre, DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS Université Paris‐Saclay Le Kremlin‐Bicêtre France

3. Université Paris Saclay Inserm, CEA, UMR 1184 ImVA‐HB Le Kremlin Bicêtre France

4. Biologic Hematology Department, Hopital Lariboisière and EA3518 Institut de Recherche Saint‐Louis, APHP.Nord, Université Paris‐Cité Paris France

5. French Reference Center for Thrombotic Microangiopathies (CNR‐MAT) Saint Antoine University Hospital, APHP, Sorbonne University Paris France

6. Hematology Department Hopital Saint‐Antoine, APHP, Sorbonne University Paris France

7. Department of Neurology Hopital Bicêtre, APHP, Université Paris Saclay Le Kremlin‐Bicêtre France

Abstract

SummaryImmune‐mediated thrombotic thrombocytopenic purpura (iTTP) is a rare and life‐threatening disease that may result from drug exposure. We report a case of iTTP occurring in a 39‐year‐old patient, 45 months following introduction of the anti‐CD52 lymphoid cell depleting monoclonal antibody alemtuzumab, to treat a relapsing‐remitting multiple sclerosis. Treatment consisted in plasma exchange, corticosteroids and caplacizumab, allowing clinical remission 3 months after the diagnosis, attested by the absence of thrombocytopenia and recovery of ADAMTS‐13 activity. As other autoimmune disorders, iTTP may occur following alemtuzumab. This diagnosis should be suspected in patients with features of thrombotic microangiopathy following this treatment.

Publisher

Wiley

Subject

Hematology

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