Affiliation:
1. Endocrinology Research Centre
2. I.M. Sechenov First Moscow State Medical University
Abstract
Multiple sclerosis (MS) is a severe chronic autoimmune demyelinating disease of the central nervous system, mediated by Th1/Th17 lymphocytes as well as B lymphocytes, macrophages and other immune cells. Some patients with MS are treated with alemtuzumab, a monoclonal antibody against CD52+ cells, which belongs to the disease-modifying therapies (DMTs). The main effect of alemtuzumab is related to changes in immune recruitment. Alemtuzumab therapy can induce secondary autoimmunity against the background of immune rebalancing. The thyroid gland is generally involved in the autoimmune process. Graves’ disease (GD) develops most often, followed by autoimmune thyroiditis.We present a clinical case of a patient with GD developed after alemtuzumab therapy for MS. The patient was referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Centre for radioiodine therapy (RAIT) due to relapse of thyrotoxicosis after anti-thyroid drug therapy for GD. The goal of treatment was achieved in 2 months, thyroid hormone therapy was initiated, against the background of this, there was compensation of thyroid function.
Publisher
Endocrinology Research Centre
Subject
Endocrinology, Diabetes and Metabolism
Reference32 articles.
1. Rassejannyj skleroz i drugie demielinizirujushhie zabolevanija. Ed. by Gusev EI, Zavalishin IA, Bojko AN. Moscow: Miklosh; 2004. — 540 p. (In Russ.).
2. Klineova S, Lublin FD. Clinical Course of Multiple Sclerosis. Cold Spring Harb Perspect Med. 2018;8(9):a028928. doi: https://doi.org/10.1101/cshperspect.a028928
3. Sawcer S. The complex genetics of multiple sclerosis: pitfalls and prospects. Brain. 2008;131(Pt12):3118-3131. doi: https://doi.org/10.1093/brain/awn081
4. ‘t Hart BA, Hintzen RQ, Laman JD. Multiple sclerosis — a response-to-damage model. Trends Mol Med. 2009;15(6):235-244. doi: https://doi.org/10.1016/j.molmed.2009.04.001
5. Demina TL, Davydovskaja MV, Hachanova NV, i dr. Rassejannyj skleroz: patogenez, diagnostika, differencial’nyj diagnoz i lechenie. Consilium medicum. 2008;(1):61-68. (In Russ.).