Tumefactive MS lesions under fingolimod A case report and literature review

被引：58

作者：

Pilz, Georg ^{[1
]}

Harrer, Andrea ^{[1
]}

Wipfler, Peter ^{[1
]}

Oppermann, Katrin ^{[1
]}

Sellner, Johann ^{[1
,2
]}

Fazekas, Franz ^{[3
]}

Trinka, Eugen ^{[1
]}

Kraus, Joerg ^{[1
]}

机构：

[1] Paracelsus Med Univ, Christian Doppler Klin, Dept Neurol, Salzburg, Austria

[2] Tech Univ Munich, Klinikum Rechts Isar, Dept Neurol, D-80290 Munich, Germany

[3] Med Univ Graz, Dept Neurol, Graz, Austria

来源：

NEUROLOGY | 2013年 / 81卷 / 19期

关键词：

RELAPSING MULTIPLE-SCLEROSIS; PLACEBO-CONTROLLED TRIAL; NATALIZUMAB; SPECTRUM; THERAPY; FTY720; BRAIN; CELLS; CSF;

D O I：

10.1212/01.wnl.0000435293.34351.11

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To report about a possible association between fingolimod treatment and tumefactive demyelinating lesions (TDL) as seen in a patient developing repeated TDL on continued fingolimod therapy. Methods: We performed serial clinical and radiologic assessments and immunophenotyping of blood and CSF immune cells. We also present a literature review about recent similar cases. Results: Clinical course and radiologic findings were consistent with diagnosis of TDL. Immune cell phenotyping showed pronounced shifts in the immune cell composition related to fingolimod treatment. In addition, we observed a subset of highly differentiated effector cells (CD45R0negCCR7neg) within the CD8 + T-cell population, which was about 2-fold enriched in the CSF compared to the peripheral blood. Conclusion: Our observations add further evidence for the development of atypical demyelinating lesions in some patients receiving fingolimod. These might be related to a treatment-associated shift in the immunopathology of specifically susceptible individuals.

引用

页码：1654 / 1658

页数：5

共 13 条

[1] SEVERE MULTIPLE SCLEROSIS RELAPSE UNDER FINGOLIMOD THERAPY: INCIDENT OR COINCIDENCE? [J].

Castrop, F. ;

Kowarik, M. C. ;

Albrecht, H. ;

Krause, M. ;

Haslinger, B. ;

Zimmer, C. ;

Berthele, A. ;

Hemmer, B. .

NEUROLOGY, 2012, 78 (12) :928-930

[2] Severe multiple sclerosis reactivation under fingolimod 3 months after natalizumab withdrawal [J].

Daelman, L. ;

Maitrot, A. ;

Maarouf, A. ;

Chaunu, M. P. ;

Papeix, C. ;

Tourbah, A. .

MULTIPLE SCLEROSIS JOURNAL, 2012, 18 (11) :1647-1649

[3] Fingolimod-associated macular edema Incidence, detection, and management [J].

Jain, Nieraj ;

Bhatti, M. Tariq .

NEUROLOGY, 2012, 78 (09) :672-680

[4] Emerging tumefactive multiple sclerosis after switching therapy from natalizumab to fingolimod [J].

Jander, Sebastian ;

Turowski, Bernd ;

Kieseier, Bernd C. ;

Hartung, Hans-Peter .

MULTIPLE SCLEROSIS JOURNAL, 2012, 18 (11) :1650-1652

[5] CSF enrichment of highly differentiated CD8+ T cells in early multiple sclerosis [J].

Jilek, Samantha ;

Schluep, Myriam ;

Rossetti, Andrea O. ;

Guignard, Laurence ;

Le Goff, Geraldine ;

Pantaleo, Giuseppe ;

Du Pasquier, Renaud A. .

CLINICAL IMMUNOLOGY, 2007, 123 (01) :105-113

[6] A Placebo-Controlled Trial of Oral Fingolimod in Relapsing Multiple Sclerosis [J].

Kappos, Ludwig ;

Radue, Ernst-Wilhelm ;

O'Connor, Paul ;

Polman, Chris ;

Hohlfeld, Reinhard ;

Calabresi, Peter ;

Selmaj, Krzysztof ;

Agoropoulou, Catherine ;

Leyk, Malgorzata ;

Zhang-Auberson, Lixin ;

Burtin, Pascale .

NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (05) :387-401

[7] Differential effects of fingolimod (FTY720) on immune cells in the CSF and blood of patients with MS [J].

Kowarik, M. C. ;

Pellkofer, H. L. ;

Cepok, S. ;

Korn, T. ;

Kuempfel, T. ;

Buck, D. ;

Hohlfeld, R. ;

Berthele, A. ;

Hemmer, B. .

NEUROLOGY, 2011, 76 (14) :1214-1221

[8] Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis [J].

Lucchinetti, C. F. ;

Gavrilova, R. H. ;

Metz, I. ;

Parisi, J. E. ;

Scheithauer, B. W. ;

Weigand, S. ;

Thomsen, K. ;

Mandrekar, J. ;

Altintas, A. ;

Erickson, B. J. ;

Koenig, F. ;

Giannini, C. ;

Lassmann, H. ;

Linbo, L. ;

Pittock, S. J. ;

Brueck, W. .

BRAIN, 2008, 131 :1759-1775

[9] Evidence for pathogenic heterogeneity in multiple sclerosis [J].

Lucchinetti, CF ;

Bruck, W ;

Lassmann, H .

ANNALS OF NEUROLOGY, 2004, 56 (02) :308-308

[10] Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder [J].

Min, Ju-Hong ;

Kim, Byoung Joon ;

Lee, Kwang Ho .

MULTIPLE SCLEROSIS JOURNAL, 2012, 18 (01) :113-115

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