It's not always an infection: Pyoderma gangrenosum of the urogenital tract in two patients with multiple sclerosis treated with rituximab.

Autor: Parrotta E; NYU Langone Multiple Sclerosis Comprehensive Care Center, 240 E. 38th St., 13th Floor, New York, NY 10016, USA., Kopinsky H; NYU Langone Multiple Sclerosis Comprehensive Care Center, 240 E. 38th St., 13th Floor, New York, NY 10016, USA., Abate J; NYU Langone Multiple Sclerosis Comprehensive Care Center, 240 E. 38th St., 13th Floor, New York, NY 10016, USA., Ryerson LZ; NYU Langone Multiple Sclerosis Comprehensive Care Center, 240 E. 38th St., 13th Floor, New York, NY 10016, USA., Krupp LB; NYU Langone Multiple Sclerosis Comprehensive Care Center, 240 E. 38th St., 13th Floor, New York, NY 10016, USA. Electronic address: Lauren.krupp@nyulangone.org.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2023 Feb; Vol. 70, pp. 104483. Date of Electronic Publication: 2022 Dec 23.
DOI: 10.1016/j.msard.2022.104483
Abstrakt: B-cell depleting therapies such as rituximab and ocrelizumab are widely used for the treatment of Multiple Sclerosis but have increased risks of adverse reactions compared to earlier MS therapies. One rarely reported reaction is pyoderma gangrenosum (PG), an inflammatory, ulcerative, skin disease of unclear etiology. Here we describe a male and female patient, each with Relapsing-Remitting Multiple Sclerosis, and both of whom developed PG while on rituximab. Both PG diagnoses were supported by persistent fever, biopsy reports of sterile neutrophilia, and leukocytosis in the absence of an identifiable infectious agent. The diagnoses were further confirmed by dramatic clinical improvement following initiation of high dose steroids and intravenous immunoglobulins, and discontinuation of rituximab.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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