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Acute sarcoidosis in a multiple sclerosis patient after alemtuzumab treatment.

Jonas Graf, Marius Ringelstein, Klaudia Lepka, Jörg Schaller, Helmut Quack, Hans-Peter Hartung, Orhan Aktas, Philipp Albrecht
Multiple Sclerosis : Clinical and Laboratory Research 2018 November
BACKGROUND: Understanding the long-term effect of alemtuzumab on the immune system of multiple sclerosis (MS) patients is crucial.

OBJECTIVE: To report a case of acute sarcoidosis (Löfgren's syndrome) in a relapsing-remitting MS patient, 1.5 years after the second course of alemtuzumab treatment.

CASE REPORT: Sarcoidosis was confirmed dermatohistologically, radiologically, and serologically. Analysis of the lymphocyte subpopulations showed a persistent effect of alemtuzumab treatment (CD4/CD8 ratio increased, absolute lymphocyte count of CD19-positive cells increased while CD3/4/8-positive cells were decreased).

CONCLUSION: Our case highlights the profound effect of alemtuzumab on the immune system and its possible risk for autoimmune complications.

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