Case report of anti-glomerular basement membrane disease following alemtuzumab treatment of relapsing-remitting multiple sclerosis

David Meyer; Alasdair Coles; Pedro Oyuela; Annie Purvis; David H Margolin

doi:10.1016/j.msard.2012.07.002

Case report of anti-glomerular basement membrane disease following alemtuzumab treatment of relapsing-remitting multiple sclerosis

Mult Scler Relat Disord. 2013 Jan;2(1):60-3. doi: 10.1016/j.msard.2012.07.002. Epub 2012 Sep 25.

Authors

David Meyer¹, Alasdair Coles², Pedro Oyuela³, Annie Purvis⁴, David H Margolin⁵

Affiliations

¹ Triad Neurological Associates, Cornerstone Health Care, 145 Kimel Park Drive, Suite 100, Winston Salem, NC 27103, USA. Electronic address: David.Meyer@cornerstonehealthcare.com.
² Department of Neurosciences, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK. Electronic address: ajc1020@medschl.cam.ac.uk.
³ Genzyme Corporation, 500 Kendall Street, Cambridge, MA 02142, USA. Electronic address: pedro.oyuela@genzyme.com.
⁴ Genzyme Corporation, 500 Kendall Street, Cambridge, MA 02142, USA. Electronic address: annie.purvis@genzyme.com.
⁵ Genzyme Corporation, 500 Kendall Street, Cambridge, MA 02142, USA. Electronic address: david.margolin@genzyme.com.

PMID: 25877456
DOI: 10.1016/j.msard.2012.07.002

Abstract

Objective: To report a case of anti-glomerular basement membrane disease (anti-GBM disease) during alemtuzumab treatment of a relapsing-remitting multiple sclerosis (RRMS) patient.

Design: Case report.

Setting: Outpatient neurology research protocol.

Patient: A 35-year-old white female receiving alemtuzumab for RRMS in a clinical research protocol developed symptoms leading to diagnosis of anti-GBM disease.

Main outcome measure: Patient response to the treatment of anti-GBM disease and RRMS.

Results: Early identification and treatment of anti-GBM disease resolved clinical symptoms and preserved renal function. Alemtuzumab treatment of RRMS resolved initial MS symptoms and appears to have controlled active disease to date.

Conclusion: Close monitoring for potential side effects of alemtuzumab treatment in RRMS resulted in a positive outcome when anti-GBM disease was recognized and treated early.

Keywords: Alemtuzumab; Anti-glomerular basement membrane disease; Autoimmune disease; Goodpasture's syndrome; Multiple sclerosis; Pulmonary renal syndrome.