scholarly journals Rituximab induced cytokine release syndrome in an MS patient: a case report

2021 ◽  
Author(s):  
Masoud Etemadifar ◽  
Mehri Salari ◽  
Mahdieh Saeri ◽  
Amirhossein Akhavan Sigari ◽  
Sara Ebrahimi
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Side Effect ◽  
Signs And Symptoms ◽  
Common Side Effect ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Relapsing Remitting ◽  
History Of ◽  
Relapsing Remitting Multiple Sclerosis

Rituximab use in multiple sclerosis has been promising. Cytokine release syndrome (CRS) is a common side effect of rituximab in patients with lymphoma. We report a case of a 44-year-old man with a history of relapsing-remitting multiple sclerosis, who presented with signs and symptoms consistent with CRS after rituximab initiation.

scholarly journals Case Report: Combining Dalfampridine with Multicomponent Exercise and Gait Training in a Person with Multiple Sclerosis

2018 ◽  
Vol 20 (5) ◽  
pp. 238-243
Author(s):  
Prudence Plummer ◽  
Corinne J. Bohling ◽  
L. Ellese Nickles ◽  
Alexis A. Williams ◽  
Amy Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Dual Task ◽  
Gait Speed ◽  
Gait Training ◽  
Important Change ◽  
Relapsing Remitting ◽  
History Of ◽  
Task Conditions ◽  
Clinically Important Change

Abstract Background: Dalfampridine extended release (D-ER) improves gait speed in some people with multiple sclerosis (MS), but many patients who take D-ER demonstrate only small improvements of questionable clinical significance. Physical therapy (PT) may augment the treatment effects of D-ER on the nervous system and improve clinical outcomes. This case report describes the successful use of D-ER combined with multicomponent PT in a patient who did not have a clinically important change in gait speed with D-ER alone. Methods: A 59-year-old woman with a 6-year history of relapsing-remitting MS was prescribed D-ER by her neurologist. After 3 weeks of D-ER therapy (10 mg twice daily), she demonstrated only a 7.1% improvement in the Timed 25-Foot Walk test. She then commenced PT consisting of two 40-minute sessions per week for 6 weeks while continuing D-ER therapy. Training focused on gait, balance, coordination, functional strengthening, and dual-task performance. Results: After 6 weeks of D-ER + PT, she had a further 14.6% improvement in Timed 25-Foot Walk gait speed, for a total improvement of 20.7%, which elevated her above the clinically meaningful threshold of 20%. Similar patterns of improvement were also observed for self-selected gait speed in single- and dual-task conditions. Improvements in fast and dual-task gait speed were retained 3 weeks later. Conclusions: For this patient, combining PT with D-ER therapy improved gait speed more than the use of D-ER alone. Further investigation of D-ER + PT or PT as an alternative to D-ER in patients with submeaningful medication response is warranted.

Quinacrine Hydrochloride-Induced Yellow Discoloration of the Skin in Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (2) ◽  
pp. 232-233
Author(s):  
Ronald J. Sokol ◽  
Philip K. Lichtenstein ◽  
Michael K. Farrell
Keyword(s):  
Case Report ◽  
Drug Administration ◽  
Side Effect ◽  
Common Side Effect ◽  
Clinical Method ◽  
The Past ◽  
Drug Of Choice ◽  
Bowel Movements ◽  
Alternative Drug ◽  
History Of

The drug of choice for treatment of giardiasis in children has changed over the past several years. Metronidazole (Flagyl) has been found to be carcinogenic in mice and mutagenic in bacteria,1 and is, therefore, no longer approved by the Food and Drug Administration for the treatment of giardiasis. Thus, quinacrine hydrochloride (Atabrine) is the recommended alternative drug for the treatment of giardiasis in children. The purpose of this report is to remind physicians of a common side effect of quinacrine hydrochloride and to call attention to a simple clinical method for its confirmation. CASE REPORT S.W., a 3-year-old white boy, had a three-week history of three to six loose, watery bowel movements per day.

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 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.

Acute exacerbation of multiple sclerosis presenting with facial metamorphopsia and palinopsia

2012 ◽  
Vol 19 (3) ◽  
pp. 369-371 ◽  
Author(s):  
Deepti Anbarasan ◽  
Jonathan Howard
Keyword(s):  
Multiple Sclerosis ◽  
Visual Pathway ◽  
Brain Lesions ◽  
Ophthalmological Examination ◽  
Occipital Region ◽  
Relapsing Remitting ◽  
History Of ◽  
Association Area ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Optic Radiations

We discuss the case of a patient with a known history of relapsing–remitting multiple sclerosis (MS) who presented with the isolated complaint of altered visual perception in the absence of abnormalities on ophthalmological examination. To the best of the authors’ knowledge, this is the first documented case of both facial metamorphopsia and palinopsia occurring as the symptoms of demyelinating brain lesions consistent with an acute MS exacerbation. These symptoms appear to be related to active demyelination that either involved the optic radiations in the visual pathway or the visual association area in the temporo-occipital region of the left hemisphere.

scholarly journals Subcutaneous interferon β-1a three times weekly and the natural evolution of gadolinium-enhancing lesions into chronic black holes in relapsing and progressive multiple sclerosis: Analysis of PRISMS and SPECTRIMS trials

2017 ◽  
Vol 3 (4) ◽  
pp. 205521731774534
Author(s):  
A Traboulsee ◽  
DKB Li ◽  
R Tam ◽  
G Zhao ◽  
A Riddehough ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Black Holes ◽  
Progressive Multiple Sclerosis ◽  
Repair Capacity ◽  
Relapsing Remitting ◽  
Mri Scans ◽  
History Of ◽  
Lesion Level ◽  
Post Hoc ◽  
Relapsing Remitting Multiple Sclerosis

Background Evolution of gadolinium-enhancing lesions into chronic black holes (CBH) may be reduced by interferon (IFN) therapy. Objective The objective of this paper is to assess the effect of IFN β-1a and placebo on CBH evolution and disability in patients with relapsing–remitting multiple sclerosis (RRMS), as well as CBH evolution in patients with secondary progressive multiple sclerosis (SPMS). Methods A post hoc, exploratory analysis of patients with RRMS and SPMS with monthly MRI scans (months –1 to 9) from two separate placebo-controlled clinical trials of IFN β-1a was conducted. Results In RRMS patients, the risk of ≥1 evolved CBH was lower for IFN β-1a versus placebo (odds ratio 0.42; p = 0.024); volume of newly evolved CBH was numerically reduced. A numerically higher proportion of patients with ≥1 evolving CBH vs no evolving CBH had confirmed three-month disability progression (four-year rate 55.8% vs 43.1%, respectively). Proportion of lesions evolving into CBH (patient level: 34.7% vs 12.6%, p < 0.0001; lesion level: 28.8% vs 11.0%, p < 0.0001) and evolved CBH volume (median 33.5 mm3 (Quartile 1, 0.0; Quartile 3, 173.4) vs 0.0 mm3 (0.0; 52.4); p = 0.0008) was higher for SPMS than RRMS patients treated with IFN β-1a. Conclusion In RRMS, IFN β-1a significantly decreased the proportion of new T1 Gd+ lesions evolving into CBH and the risk of developing a CBH. In patients with SPMS, more lesions develop to CBH, indicating reduced repair capacity, and the natural history of lesion development appears to be unaffected by IFN β-1a treatment.

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.

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