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

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