title: Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in relapsing-remitting multiple sclerosis patients on high-dose interferon β.
abstract: Three women aged 34-47 years old, on high dose interferon beta-1a for relapsing-remitting multiple sclerosis, were hospitalized between 2009-2012 for thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Patients sought medical attention for neurological symptoms including cephalalgia, blurred vision, confusion, focal deficits and seizures. All patients presented thrombocytopenia, hemolytic anemia and arterial hypertension. Despite plasma exchanges, corticosteroids and anti-CD20 treatments, all patients progressed towards severe renal insufficiency and one patient died of hemorrhagic shock. In this report we identify a rare but morbid complication of interferon beta-1a treatment associated with female gender, Caucasian background and low body mass index.
authors.affiliation: Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada Department of Neurology, Université de Montréal, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Larochelle
authors.affiliation: Department of Neurology, Université de Sherbrooke, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Grand'maison
authors.affiliation: Department of Neurology, Université de Montréal, Canada.
authors.forename: Gilles P
authors.initials: GP
authors.lastname: Bernier
authors.affiliation: Department of Pathology, Université de Montréal, Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Latour
authors.affiliation: Department of Medicine, Université de Montréal, Canada.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cailhier
authors.affiliation: Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada Department of Neurology, Université de Montréal, Canada a.prat@umontreal.ca.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Prat
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced*; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000009:adverse effects*; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced*
chemical_list: D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D000068556:Interferon beta-1a
keywords: Multiple sclerosis; hemolytic anemia; interferon beta; renal insufficiency; thrombocytopenia; thrombotic thrombocytopenic purpura-hemolytic uremic syndrome