Cerebral toxoplasmosis in an MS patient receiving Fingolimod

Publication date: Available online 12 May 2017 Source:Multiple Sclerosis and Related Disorders Author(s): Alejandro Enriquez-Marulanda, Jaime Valderrama-Chaparro, Laura Parrado, Juan Diego Vélez, Ana Maria Granados, Jorge Luis Orozco, Jairo Quiñones Multiple Sclerosis (MS) is an autoimmune disease in which lymphocytes target putative myelin antigens in the CNS, causing inflammation and neurodegeneration. Fingolimod (FTY720) is an immunosuppressive drug used as a second line therapy for relapsing forms of MS due to its safety profile and good response to treatment. Despite its safety, there are still concerns about the possibility of Fingolimod being linked to the development of opportunistic infections like disseminated varicella zoster infections and herpes simplex encephalitis. In this case report, we describe one patient with past medical history of MS in current treatment with Fingolimod for the last year which presents herself with hemiparesis, fever and fatigue. The initial MRI showed multiple demyelinating-like lesions that could have corresponded to the tumefactive form of MS relapse. The blood work up revealed leukopenia with lymphopenia and a CD4+ count of 200 cell/mm3. Treatment for acute relapse was initiated with little to no response. Further examination was carried by the clinicians, a lumbar puncture was performed and it showed pleocytosis with increased protein levels. Later, several serologic studies were performed and both IgM and IgG antibodies ...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research