Autoimmune hepatitis after high-dose intravenous methylprednisolone pulse in RR-MS

Open Medicine ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 356-359
Author(s):  
Reinhard Reuß ◽  
Kerstin Retzlaff ◽  
Sabine Vogel ◽  
Folker Franke ◽  
Patrick Oschmann
Keyword(s):  
Multiple Sclerosis ◽  
Lymphocytic Infiltration ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
Relapsing Remitting ◽  
Liver Transaminases ◽  
Rebound Phenomenon ◽  
Intravenous Methylprednisolone Pulse ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Glutamyl Transpeptidase

AbstractThree weeks after the administration of intravenous methylprednisolone therapy, a 42-year-old female patient suffering from relapsing-remitting multiple sclerosis (RR-MS) presented with a profound elevation of liver transaminases (GOT 485 U/l, GPT 1082 U/l, glutamyl transpeptidase 170 U/l). Liver biopsy revealed a profound, still active hepatitis with portal lymphocytic infiltration and fibrosis. Most likely, existing acute hepatitis was of autoimmune origin and emerged from an immune rebound phenomenon after immunosuppressive therapy.

scholarly journals Venous Thrombosis in Multiple Sclerosis Patients after High-Dose Intravenous Methylprednisolone: The Preventive Effect of Enoxaparin

Thrombosis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Hossein Kalanie ◽  
Ali Amini Harandi ◽  
Shapoor Alidaei ◽  
Daryoosh Heidari ◽  
Saeed Shahbeigi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Venous Thrombosis ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
Relapsing Remitting ◽  
Acute Attacks ◽  
Multiple Sclerosis Patients ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Preventive Role

Aim. This study was designed to examine the possible role of high-dose intravenous methylprednisolone (IVMP) in the development of venous thrombosis (VT). The cerebral one anecdotally had been reported in patients with relapsing remitting multiple sclerosis (RRMS) in acute attacks and the possible preventive role of enoxaparin. Material and Methods. From a pool of 520 patients, 388 patients with definite RRMS who fulfilled entry characteristics were selected and randomly received either a 5-day course of daily 1 gr IVMP or the aforementioned plus 5 days of daily subcutaneous 40 units of enoxaparin according to a predefined protocol. Results. Mean age, gender ratio, mean relapse rate, and EDSS were similar in both groups of patients (P > 0.05). Finally, 366 patients remained in the study. Of 188 patients treated with IVMP with 855 relapses, 5 developed VT (0.37% per patient per year and 0.58% per each course of IVMP) within 3 to 15 days of starting therapy. None of the 178 patients who experienced 809 relapses who received IVMP plus enoxaparin developed such complications. Conclusion. The study implies that high-dose IVMP in MS exacerbation may increase the risk of VT and prophylactic anticoagulant treatment in this setting is warranted.

Determinants of Gd-enhanced MRI response to IFN-β-1a treatment in relapsing-remitting multiple sclerosis

1998 ◽  
Vol 4 (5) ◽  
pp. 403-407 ◽  
Author(s):  
T Koudriavtseva ◽  
C Pozzilli ◽  
M Fiorelli ◽  
C Gasperini ◽  
F Bagnato ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Period ◽  
Early Response ◽  
High Dose ◽  
Late Response ◽  
Relapsing Remitting ◽  
Change In The Mean ◽  
Remitting Multiple Sclerosis ◽  
Pre Treatment ◽  
Relapsing Remitting Multiple Sclerosis

The decision to use interferon beta (IFN-b) as a treatment for relapsing-remitting multiple sclerosis (RRMS) is based on both clinical characteristics and course of the disease. To better identify the profile of responders, the relationships between baseline clinical/MRI characteristics and therapeutical response was analyzed in 49 patients with RRMS randomly assigned to receive subcutaneously 3 or 9 MIU of IFN-b-1a. The therapeutical response was evaluated as a per cent change in the mean number and volume of monthly Gd-enhancing lesions in both first (early response) and second (late response) 6-month period of treatment, compared to the 6-month pre-treatment period. A better early response was seen in patients with a lower number of relapses during the pre-treatment period, while the late response was favourably influenced by a lower baseline EDSS and the high dose. Our findings suggest that the effect of IFN-b-1a on disease MRI activity is dose-related and dependent on the relapse rate and the level of disability before treatment.

Residual disability after severe relapse in people with multiple sclerosis treated with disease-modifying therapy

2018 ◽  
Vol 25 (13) ◽  
pp. 1746-1753 ◽  
Author(s):  
Anat Achiron ◽  
Ida Sarova-Pinhas ◽  
David Magalashvili ◽  
Yael Stern ◽  
Aviva Gal ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Status ◽  
High Rate ◽  
High Dose ◽  
Disease Modifying Drugs ◽  
Disease Modifying Therapy ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Relapsing Remitting Multiple Sclerosis

Background: The rate of post-relapse residual disability in patients with relapsing–remitting multiple sclerosis (RRMS) treated with disease-modifying drugs (DMD) has not been studied. Objective: To assess relapse residual disability in DMD-treated RRMS patients. Methods: We followed DMD-treated RRMS patients presenting with acute relapse who received high-dose steroids. Increases in Expanded Disability Status Scale (EDSS) of at least 2.0, 1.0–1.5 or 0.5 were defined as severe, moderate or mild relapses, respectively. The proportions of patients with post-relapse residual disability defined as the failure to regain pre-relapse neurological status at 1, 4 and 12 months were evaluated. Results: Out of 1672 relapses in DMD-treated RRMS patients, 17% were severe. In patients who presented with a severe relapse, we observed post-relapse residual disability of at least 1.0 EDSS point in 60.1%, 55.9% and 48.2% of patients at 1, 2 and 12 months of follow-up, respectively. Post-relapse residual disability of at least 2.0 EDSS points was observed in 37.4%, 30.7% and 20.7% of patients after 1, 2 and 12 months, respectively. Conclusion: A high rate of incomplete recovery was seen 12 months following severe relapse among RRMS patients and may contribute to the accumulation of long-term disability.

Sign in / Sign up

Export Citation Format

Share Document