Anti-double stranded DNA and lupus syndrome induced by interferon-beta therapy in a patient with multiple sclerosis.
We present a 43-year-old woman with relapsing-remitting multiple sclerosis (MS) who developed lupus syndrome after 32 months of IFN-beta-1a therapy. She presented with malaise, myalgia, arthralgia and fever. Laboratory tests showed high erythrocyte sedimentation rate, anaemia and lymphopenia. Antibodies to double stranded DNA (dsDNA) of IgG, IgM and IgA classes were detected on Critidia luciliae. Additionally, high levels of anti-nucleosomal antibodies, low levels of anti-histone and anti-Ro/SSA antibodies were also found. Diagnosis of drug-induced SLE was established. Treatment with IFN-beta was discontinued and oral prednisone was started. Twelve weeks after cessation of IFN-beta therapy, the patient's symptoms completely resolved and autoantibodies disappeared. To the best of our knowledge, this is the first report of a patient with MS in whom treatment with IFN-beta induced lupus syndrome and antibodies to dsDNA and nucleosome.
Bonaci-Nikolic
B
B
Institute of Allergy and Clinical Immunology, Clinical Center of Serbia, Belgrade, Serbia.
Jeremic
I
I
Andrejevic
S
S
Sefik-Bukilica
M
M
Stojsavljevic
N
N
Drulovic
J
J
D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000974:Antibodies, Antinuclear / Q000187:drug effects* / Q000378:metabolism; D004247:DNA / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000503:physiopathology; D009103:Multiple Sclerosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use
D000276:Adjuvants, Immunologic; D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D016899:Interferon-beta; D004247:DNA; D011241:Prednisone; D000068556:Interferon beta-1a