Cladribine transfer into human milk: A case report

2020 ◽  
pp. 135245852091217
Author(s):  
Palika Datta ◽  
Andrea I Ciplea ◽  
Kathleen Rewers-Felkins ◽  
Teresa Baker ◽  
Ralf Gold ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mass Spectrometry ◽  
Case Report ◽  
Human Milk ◽  
Liquid Chromatography Mass Spectrometry ◽  
Milk Samples ◽  
First Case ◽  
Relapsing Remitting ◽  
Infant Dose ◽  
Relapsing Remitting Multiple Sclerosis

Background: Cladribine is an antimetabolite used for the treatment of relapsing–remitting multiple sclerosis. At present, there are no data available on its use in breastfeeding mothers and its transfer in human milk. Objective: We present a case of a lactating mother who donated her milk samples to study the transfer of cladribine following a 20-mg oral dose. Methods: Analysis was done using liquid chromatography–mass spectrometry. Results: The relative infant dose calculated in this study was 3.06%. Conclusion: This is the first case report suggesting the transfer of cladribine in human milk in measurable quantities. However, caution should be advised during lactation.

scholarly journals Dimethyl fumarate transfer into human milk

2020 ◽  
Vol 13 ◽  
pp. 175628642096841
Author(s):  
Andrea I. Ciplea ◽  
Palika Datta ◽  
Kathleen Rewers-Felkins ◽  
Teresa Baker ◽  
Ralf Gold ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Human Milk ◽  
Dimethyl Fumarate ◽  
Liquid Chromatography Mass Spectrometry ◽  
Primary Metabolite ◽  
Milk Samples ◽  
Relapsing Remitting ◽  
Infant Dose ◽  
Monomethyl Fumarate ◽  
Relapsing Remitting Multiple Sclerosis

Dimethyl fumarate (DMF) is approved for the treatment of relapsing-remitting multiple sclerosis. It is unknown whether DMF or its primary metabolite monomethyl fumarate (MMF) are excreted into human milk. We present two cases of lactating patients who donated milk samples to study the transfer of MMF into human milk following a week of 2 × 240 mg daily oral dose. Samples were analyzed using liquid chromatography mass spectrometry. The calculated relative infant dose was 0.019% and 0.007%. This is the first study to demonstrate that MMF is transferred into human milk, with only limited exposure to an infant.

scholarly journals A possible case of serum sickness after ocrelizumab infusion – Commentary

2020 ◽  
Vol 27 (1) ◽  
pp. 158-159
Author(s):  
Sarmad Al-Araji ◽  
Olga Ciccarelli
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Hypersensitivity Reaction ◽  
Current Literature ◽  
Immune Complexes ◽  
Serum Sickness ◽  
The Third ◽  
Relapsing Remitting ◽  
Delayed Hypersensitivity Reaction ◽  
Relapsing Remitting Multiple Sclerosis

Serum sickness is a type III delayed hypersensitivity reaction which causes deposition of immune-complexes in the tissues. It has been reported with rituximab, and in this issue of the journal, there is a case report of a patient with relapsing remitting multiple sclerosis who developed a possible serum sickness after the third infusion of ocrelizumab. In this commentary, we discuss the current literature on serum sickness, and how to diagnose and manage it. We provide our opinion on this particular case, and encourage neurologists and patients to remain vigilant of such a possibility.

25-Hydroxyvitamin D in cerebrospinal fluid during relapse and remission of multiple sclerosis

2009 ◽  
Vol 15 (11) ◽  
pp. 1280-1285 ◽  
Author(s):  
Trygve Holmøy ◽  
Stine Marit Moen ◽  
Thomas A Gundersen ◽  
Michael F Holick ◽  
Enrico Fainardi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mass Spectrometry ◽  
Cerebrospinal Fluid ◽  
Neurological Diseases ◽  
Hypovitaminosis D ◽  
Serum Levels ◽  
Liquid Chromatography Mass Spectrometry ◽  
Hydroxyvitamin D ◽  
Relapsing Remitting ◽  
25 Hydroxyvitamin D

Hypovitaminosis D may play a role in multiple sclerosis (MS), but little is known about intrathecal vitamin D. 25-Hydroxyvitamin D was measured in cerebrospinal fluid and sera from 36 patients with relapsing-remitting MS, 20 patients with other inflammatory neurological diseases and 18 patients with non-inflammatory neurological diseases with liquid chromatography-mass spectrometry. There were no significant differences in cerebrospinal fluid concentrations of 25-hydroxyvitamin D, but the cerebrospinal fluid:serum ratio was significantly lower in MS compared with other inflammatory neurological diseases (p=0.0012) and non-inflammatory neurological diseases (p=0.041) patients. The concentrations of 25-hydroxyvitamin D in cerebrospinal fluid and serum were positively correlated and their ratio was similar to that of albumin. Neither the concentrations of 25-hydroxyvitamin D in cerebrospinal fluid or serum nor their ratio were associated with the presence of relapses or gadolinium-enhanced lesions. These results do not support that 25-hydroxyvitamin D is actively transported to the cerebrospinal fluid, or that the cerebrospinal fluid or serum levels or their ratio exert a major impact on MS activity.

scholarly journals A Case Report of Relapsing Remitting Multiple Sclerosis: Getting the Diagnosis Sooner

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Fuentes S ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Early Diagnosis ◽  
Disease Process ◽  
Diagnosis And Treatment ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Multiple sclerosis can often present with nonspecific symptoms leading to difficulty in establishing a diagnosis early in the disease process. Early diagnosis and treatment is of importance due to the associated decrease in disability for those that get treatment sooner. Here we present a case with a patient the presented with changes in vision and paresthesias. Her initial workup from the neurologist was negative and further workup was delayed until her symptoms worsened. After worsening symptoms, MRI revealed that multiple sclerosis was the cause of her symptoms.

Sudden cardiac death in multiple sclerosis caused by active demyelination of the medulla oblongata

2011 ◽  
Vol 17 (9) ◽  
pp. 1146-1148 ◽  
Author(s):  
GJD Hengstman ◽  
B Kusters
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Sudden Cardiac Death ◽  
Medulla Oblongata ◽  
Cardiac Death ◽  
Sudden Onset ◽  
Cardiac Arrythmias ◽  
First Case ◽  
Relapsing Remitting ◽  
Demyelinating Lesions

Cardiovascular autonomic dysfunction is not uncommon in multiple sclerosis (MS) and is related to the involvement of the vegetative areas of cardiac innervations in the medulla oblongata. It has been suggested that this may contribute to the occurrence of sudden death in MS. In this case report, we present a patient with active relapsing–remitting MS who died unexpectedly due to the sudden onset of cardiac arrythmias. Post-mortem examination showed the presence of active demyelinating lesions in the medulla oblongata. As far as we know, this is the first case report clearly linking sudden cardiac death to active MS on the histopathological level.

scholarly journals Acute myeloid leukaemia induced by mitoxantrone: case report

2005 ◽  
Vol 63 (2a) ◽  
pp. 327-329 ◽  
Author(s):  
Walter Oleschko Arruda ◽  
María Belén Montú ◽  
Marcelo de Souza R. de Oliveira ◽  
Ricardo Ramina
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Acute Myeloid Leukaemia ◽  
Progressive Multiple Sclerosis ◽  
White Female ◽  
Severe Thrombocytopenia ◽  
Relapsing Remitting ◽  
Low Incidence ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Acute Myeloid

Mitoxantrone (MX) is an immunosupressant drug used in secondarily progressive multiple sclerosis (SPMS) and in relapsing-remitting multiple sclerosis (RRMS). It has a leukemogenesis potential induced by cytogenetic abnormalities, though with a low incidence. Promyelocitic leukaemia (type M3) and other forms of acute myeloblastic leukaemias (M4 and M5) have been described in a few MS patients who received MX during their treatment. We describe a white female patient, 47 year-old, with SPMS (EDSS = 4) with 14 years of disease. She received MX during her disease and developed acute promyelocytic leukaemia (M3), with severe thrombocytopenia 30 months later. She ultimately died due to intracerebral hemorrhage. Other cases of treatment related to AML are reviewed and discussed.

scholarly journals DGI-037 Fingolimod in Relapsing Remitting Multiple Sclerosis: A Case Report

2013 ◽  
Vol 20 (Suppl 1) ◽  
pp. A109.1-A109
Author(s):  
M Merchante ◽  
A Izquierdo ◽  
S Martinez ◽  
AP Zorzano ◽  
L Sanchez-Rubio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

scholarly journals Erythropoietin therapy in a case of neonatal anemia after exposure to natalizumab throughout pregnancy

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Elisabetta Godano ◽  
Fabio Barra ◽  
Alessandra Allodi ◽  
Antonella Ferraiolo ◽  
Alice Laroni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Unplanned Pregnancy ◽  
Critical Role ◽  
Highly Active ◽  
Relapsing Remitting ◽  
The Status ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Maternal Disease

Abstract Background Natalizumab is a monoclonal antibody approved for the treatment of patients with relapsing-remitting multiple sclerosis. According to the current clinical recommendations, its use during pregnancy should be carefully evaluated only in women with highly active disease who plan a pregnancy or have an unplanned pregnancy, after accurate counseling about eventual maternal disease relapse due to therapy suspension. Case presentation This brief case report describes a case of documented anemia that we observed in a newborn whose mother with relapsing-remitting multiple sclerosis was treated with an extended dosing protocol of natalizumab throughout pregnancy. The newborn received the infusion of erythropoietin every seven days from the fortieth day of life; subsequently, the status of anemia underwent clinical resolution. Conclusions This case report confirmed that natalizumab can cause disorders of hematopoiesis, including anemia, thrombocytopenia, or pancytopenia, in newborns of patients treated during pregnancy. A multidisciplinary team, including experienced pediatricians and pediatric hematologists, has a critical role in managing newborns delivered by women, being treated with natalizumab for treating relapsing-remitting multiple sclerosis during pregnancy.

Sign in / Sign up

Export Citation Format

Share Document