Two cases of diabetes mellitus type 1 after alemtuzumab treatment for multiple sclerosis: another probable secondary autoimmune disease
Alemtuzumab (ATZ) is an established highly effective treatment in relapsing-remitting multiple sclerosis (RRMS) [1, 2, 3]. Secondary autoimmune disorders in MS patients treated with alemtuzumab have been reported in a frequency of about 40% for thyroid disorders, 3% for thrombocytopenic purpura (ITP) and below 0.3% for glomerulonephritis . So far, one case of diabetes type 1 (T1D) as a possible secondary autoimmune disease following alemtuzumab treatment has been published .
We report on two patients who had an acute increase in their blood glucose level several months after the second course of alemtuzumab. In both cases, a diagnosis of T1D was made. In addition, thyroid disorders occurred in both cases over the course of time.
A 37-year-old male patient had the first symptoms of RRMS at the age of 19. He had no history of autoimmune disorders, but his mother has MS reaching immobility at the age of 50. During interferon therapy, he experienced about one...
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Conflicts of interest
Stephan Richter has received honoraria for advisory board councils and travel expenses for attending meetings from Biogen, Celgene, Genzyme, Merck, Novartis and Roche. Bert Wagner has received honoraria for advisory board councils and travel expenses for attending meetings from Biogen, Genzyme, Merck, Novartis and Roche. Elisabeth G. Celius has received honoraria for advisory boards and/or speaker honoraria from Biogen, Merck, Roche, Novartis, Genzyme and Teva, and unrestricted research grants from Novartis and Genzyme.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Cohen JA, Coles AJ, Arnold DL, Confavreux C, Fox EJ, Hartung HP, Havrdova E, Selmaj KW, Weiner HL, Fisher E, Brinar VV, Giovannoni G, Stojanovic M, Ertik BI, Lake SL, Margolin DH, Panzara MA, Compston DA (2012) Investigators C-MI. Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomized controlled phase 3 trial. Lancet 380:1819–1828CrossRefGoogle Scholar
- 2.Coles AJ, Twyman CL, Arnold DL, Cohen JA, Confavreux C, Fox EJ, Hartung HP, Havrdova E, Selmaj KW, Weiner HL, Miller T, Fisher E, Sandbrink R, Lake SL, Margolin DH, Oyuela P, Panzara MA, Compston DA (2012) Investigators C-MI. Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial. Lancet 380:1829–1839CrossRefGoogle Scholar
- 4.Coles AJ, Cohen JA, Fox EJ, Giovannoni G, Hartung HP, Havrdova E, Schippling S, Selmaj KW, Traboulsee A, Compston DAS, Margolin DH, Thangavelu K, Chirieac MC, Jody D, Xenopoulos P, Hogan RJ, Panzara MA, Arnold DL (2017) Alemtuzumab CARE-MS II 5-year follow-up: Efficacy and safety findings. Neurology 89:1117–1126CrossRefGoogle Scholar
- 10.Della Valle P, Coluccia A, Martinelli V, Comi G, D´Angelo A, Moiola L (2018) Acquired haemophilia a as a secondary autoimmune disease after alemtuzumab treatment in multiple sclerosis: a case report. Mult Scler Relat Disord 27:403–405Google Scholar