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Graves’ disease with spontaneous resolution following ocrelizumab in primary progressive multiple sclerosis

2021-09Journal article Open access
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dc.contributor.authorDuarte, Diana Borges
dc.contributor.authorSilva, Ana Martins
dc.contributor.authorFreitas, Claudia
dc.contributor.authorCardoso, Helena
dc.date.accessioned2024-01-30T13:50:46Z
dc.date.available2024-01-30T13:50:46Z
dc.date.issued2021-09
dc.description.abstractObjectives. Immune reconstitution therapies (IRT), which include antibody-based cell-depleting therapies targeting CD52+ (alemtuzumab) or CD20+ (rituximab, ocrelizumab) leukocytes, are approved for the treatment of multiple sclerosis. Thyroid autoimmunity is a common adverse effect of alemtuzumab treatment, Graves' disease (GD) being the most prevalent manifestation. To date, thyroid autoimmunity events have not been reported with CD20-targeting monoclonal antibodies. Case Report. A 59-year-old woman with primary progressive multiple sclerosis with no prior personal history of thyroid disease or autoimmunity, was diagnosed with GD 6 months following the first ocrelizumab infusion. She was asymptomatic and had no signs of ophthalmopathy. Due to the temporal association of GD diagnosis with ocrelizumab infusion, absence of symptoms and our experience with alemtuzumab-induced GD, we decided for an active surveillance strategy and antithyroid drugs were not started. She underwent spontaneous resolution of hyperthyroidism with thyroid-stimulating hormone (TSH) receptor antibodies (TRAb) negativity and a mild and transitory period of subclinical hypothyroidism, while she continued the biannually ocrelizumab administration schedule. To present date, she has maintained close clinical and biochemical surveillance with normal TSH, free thyroxine (fT4) and free triiodothyronine (fT3) levels and undetectable TRAb. Conclusions. This is the first case of GD reported after ocrelizumab administration. The timing, onset and course of this case is similar to alemtuzumab-induced GD, usually interpreted as an "immune reconstitution syndrome"; however, ocrelizumab cell count depletion is inferior in severity, cell population affected and duration of depletion. This case highlights the importance of pre-screening and follow-up with thyroid function tests in patients treated with ocrelizumab. As a novel therapeutic antibody, further investigation is required to unravel the causes of thyroid autoimmunity.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationDuarte DB, Silva AMD, Freitas C, Cardoso H. Graves' disease with spontaneous resolution following ocrelizumab in primary progressive multiple sclerosis. Endocr Regul. 2021;55(3):169-173. doi:10.2478/enr-2021-0018pt_PT
dc.identifier.doi10.2478/enr-2021-0018pt_PT
dc.identifier.issn1210-0668
dc.identifier.issn1336-0329
dc.identifier.urihttp://hdl.handle.net/10400.16/2912
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWalter de Gruyterpt_PT
dc.relation.publisherversionhttps://sciendo.com/article/10.2478/enr-2021-0018pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectGraves´ diseasept_PT
dc.subjectimmune reconstitution therapypt_PT
dc.subjectmultiple sclerosispt_PT
dc.subjectocrelizumabpt_PT
dc.titleGraves’ disease with spontaneous resolution following ocrelizumab in primary progressive multiple sclerosispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceGermanypt_PT
oaire.citation.endPage173pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage169pt_PT
oaire.citation.titleEndocrine Regulationspt_PT
oaire.citation.volume55pt_PT
person.familyNameDuarte
person.familyNameMartins da Silva
person.familyNameCardoso
person.givenNameDiana
person.givenNameAna
person.givenNameMaria Helena
person.identifier1094737
person.identifier.ciencia-id1116-6606-5CF5
person.identifier.ciencia-id0212-CE45-8889
person.identifier.orcid0000-0001-8910-6888
person.identifier.orcid0000-0002-1409-0831
person.identifier.orcid0000-0002-9465-5918
person.identifier.ridP-6822-2017
person.identifier.scopus-author-id57222620371
person.identifier.scopus-author-id56817857700
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication3c67b620-3b54-4dec-8e4e-8deb70a73d20
relation.isAuthorOfPublicatione2fd5aa2-f733-43eb-b339-14fcaa3d881d
relation.isAuthorOfPublicationa1dc4387-f35c-447a-be66-d81fc5fde281
relation.isAuthorOfPublication.latestForDiscovery3c67b620-3b54-4dec-8e4e-8deb70a73d20

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