title: Favorable outcome of interferon-beta associated thrombotic microangiopathy following treatment with corticosteroids, plasma exchange and rituximab: A case report.
abstract: Thrombotic microangiopathy (TMA) is a rare but increasingly recognized complication of interferon-beta therapy, which can be associated with serious sequelae. We report on a 53-year-old woman with a longstanding history of relapsing-remitting multiple sclerosis, who developed TMA after 15 years of high-dose treatment with subcutaneous interferon-beta-1a. The patient presented with headaches, an epileptic seizure, confusion, and arterial hypertension. Laboratory findings included thrombocytopenia and hemolytic anemia. Despite of severe clinical manifestations and pronounced laboratory abnormalities, therapy with corticosteroids, plasma exchange and rituximab was associated with a favorable outcome and return to her premorbid level of functioning.
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117 Germany.
authors.forename: Lea M
authors.initials: LM
authors.lastname: Gerischer
authors.affiliation: Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117 Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Siebert
authors.affiliation: Department of Neurology, Jüdisches Krankenhaus Berlin, Heinz-Galinski-Strasse 1, Berlin, 13347 Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Janke
authors.affiliation: Department of Neurology, Jüdisches Krankenhaus Berlin, Heinz-Galinski-Strasse 1, Berlin, 13347 Germany; Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117 Germany.
authors.forename: Gerhard Jan
authors.initials: GJ
authors.lastname: Jungehuelsing
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117 Germany. Electronic address: klemens.ruprecht@charite.de.
authors.forename: Klemens
authors.initials: K
authors.lastname: Ruprecht
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D010951:Plasma Exchange; D000069283:Rituximab / Q000627:therapeutic use*; D057049:Thrombotic Microangiopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007155:Immunologic Factors; D000069283:Rituximab; D016899:Interferon-beta
keywords: Hemolytic anemia; Hemolytic uremic syndrome; Interferon beta; Multiple sclerosis; Thrombocytopenia; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura