Alemtuzumab-induced Graves’ disease
M. S. Sheremeta,
M. O. Korchagina,
R. M. Guseinova,
T. E. Schmidt,
K. S. Nizhegorodova,
N. Yu. Sviridenko,
G. A. Melnichenko https://doi.org/10.14341/probl13238
Abstract
Multiple sclerosis (MS) is a severe chronic autoimmune demyelinating disease of the central nervous system, mediated by Th1/Th17 lymphocytes as well as B lymphocytes, macrophages and other immune cells. Some patients with MS are treated with alemtuzumab, a monoclonal antibody against CD52+ cells, which belongs to the disease-modifying therapies (DMTs). The main effect of alemtuzumab is related to changes in immune recruitment. Alemtuzumab therapy can induce secondary autoimmunity against the background of immune rebalancing. The thyroid gland is generally involved in the autoimmune process. Graves’ disease (GD) develops most often, followed by autoimmune thyroiditis.
We present a clinical case of a patient with GD developed after alemtuzumab therapy for MS. The patient was referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Centre for radioiodine therapy (RAIT) due to relapse of thyrotoxicosis after anti-thyroid drug therapy for GD. The goal of treatment was achieved in 2 months, thyroid hormone therapy was initiated, against the background of this, there was compensation of thyroid function.
About the Authors
M. S. Sheremeta
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Marina S. Sheremeta – PhD.
Moscow
Competing Interests:
None
M. O. Korchagina
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Maria O. Korchagina - PhD, student.
11 Dm. Ulyanova street, 117036 Moscow
Competing Interests:
None
R. M. Guseinova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Raisat M. Guseinova – MD.
Moscow
Competing Interests:
None
T. E. Schmidt
I.M. Sechenov First Moscow State Medical University
Russian Federation
Competing Interests:
Russian Federation
Tatiana E. Schmidt – PhD.
Moscow
Competing Interests:
None
K. S. Nizhegorodova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Kseniya S. Nizhegorodova – MD.
Moscow
Competing Interests:
None
N. Yu. Sviridenko
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Natalya Yu. Sviridenko - MD, PhD, Professor.
Moscow
Competing Interests:
None
G. A. Melnichenko
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Galina A. Melnichenko - MD, PhD, Professor.
Moscow
Competing Interests:
None
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1. Figure 1. Thyroid scintigraphy with 99mTc-pertechnetate after intravenous administration of radiopharmaceuticals (07/06/2022). Signs of diffuse enhancement of radiopharmaceutical capture. | |
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2. Figure 2. Mechanism of action of alemtuzumab | |
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3. Figure 3. Algorithm for managing a patient with MS receiving alemtuzumab | |
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For citations:
Sheremeta M.S., Korchagina M.O., Guseinova R.M., Schmidt T.E., Nizhegorodova K.S., Sviridenko N.Yu., Melnichenko G.A. Alemtuzumab-induced Graves’ disease. Problems of Endocrinology. 2023;69(3):51-57. (In Russ.) https://doi.org/10.14341/probl13238
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