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Forschungsdatenbank PMU-SQQUID

Tumefactive MS lesions under fingolimod: a case report and literature review.
Pilz, G; Harrer, A; Wipfler, P; Oppermann, K; Sellner, J; Fazekas, F; Trinka, E; Kraus, J;
Neurology. 2013; 81(19): 1654-1658.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Harrer Andrea
Kraus Jörg
Oppermann Katrin
Pilz Georg
Sellner Johann
Trinka Eugen
Wipfler Peter

Abstract

OBJECTIVE
To report about a possible association between fingolimod treatment and tumefactive demyelinating lesions (TDL) as seen in a patient developing repeated TDL on continued fingolimod therapy.
We performed serial clinical and radiologic assessments and immunophenotyping of blood and CSF immune cells. We also present a literature review about recent similar cases.
Clinical course and radiologic findings were consistent with diagnosis of TDL. Immune cell phenotyping showed pronounced shifts in the immune cell composition related to fingolimod treatment. In addition, we observed a subset of highly differentiated effector cells (CD45R0negCCR7neg) within the CD8+ T-cell population, which was about 2-fold enriched in the CSF compared to the peripheral blood.
Our observations add further evidence for the development of atypical demyelinating lesions in some patients receiving fingolimod. These might be related to a treatment-associated shift in the immunopathology of specifically susceptible individuals.


Useful keywords (using NLM MeSH Indexing)

Adolescent

Brain/pathology*

Female

Fingolimod Hydrochloride

Follow-Up Studies

Humans

Immunosuppressive Agents/therapeutic use*

Magnetic Resonance Imaging

Multiple Sclerosis/cerebrospinal fluid

Multiple Sclerosis/drug therapy*

Multiple Sclerosis/immunology*

Oligoclonal Bands/cerebrospinal fluid

Plasma Exchange

Propylene Glycols/therapeutic use*

Sphingosine/analogs*

derivatives*

Sphingosine/therapeutic use