Emerging tumefactive MS after switching therapy from interferon-beta to fingolimod: A case report.
We describe a case of tumefactive multiple sclerosis, based on characteristic imaging features and excluding alternative diagnoses, presented with relapse 18 weeks after switching betaferon to fingolimod. Recent reported cases of this paradoxical demyelinating reaction in a setting of fingolimod-related immune system alterations seem to be something more than an accidental event. Immune cell shifting underlying a genetic susceptibility factor has been suggested to participate in this disastrous adverse effect. It could be a warning sign which physicians should take it into account for better recognition of patients at risk and select candidates for this management.
Iranian Center of Neurological Research, Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
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Harirchian
Iranian Center of Neurological Research, Neurology Department, Tehran University of Medical Sciences, Tehran, Iran.
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Taalimi
Iranian Center of Neurological Research, Neurology Department, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: b-siroos@razi.tums.ac.ir.
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Siroos
D000328:Adult; D003937:Diagnosis, Differential; D000068876:Fingolimod Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016899:Interferon-beta / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D066244:Proton Magnetic Resonance Spectroscopy; D014054:Tomography
D007166:Immunosuppressive Agents; D016899:Interferon-beta; D000068876:Fingolimod Hydrochloride
Fingolimod; Immune cell shifting; Tumefactive demyelinating lesion