Alemtuzumab-associated diffuse alveolar damage – a case report

• Published in: BMC neurology Vol. 20; no. 1; pp. 1 - 357
• Main Authors: Bayas, Antonios, Menacher, Martina, Schwaiblmair, Martin, Märkl, Bruno, Naumann, Markus
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 23.09.2020; BioMed Central; BMC
• Subjects: Alemtuzumab; Alveoli; Antibodies; Biopsy; Care and treatment; Case Report; Case reports; Cough; Diagnosis; Diffuse alveolar damage; Dyspnea; Fingolimod; Hemorrhage; Infections; Lung diseases; Lungs; Magnetic resonance imaging; Membranes; Monoclonal antibodies; Mortality; Multiple sclerosis; Patients; Respiration; Respiratory distress syndrome; Thyroid gland
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-020-01934-7

Abstract Background Identifying causes of alemtuzumab induced respiratory symptoms in Multiple Sclerosis (MS) patients is crucial. Case presentation We report a case of diffuse alveolar damage (DAD) in a patient with MS after the first course of alemtuzumab treatment. A 42-year-old female developed progressive non-productive cough and exertional dyspnea 2 months after alemtuzumab treatment. DAD was diagnosed histopathologically by lung biopsy. The patient recovered completely, alemtuzumab was not continued. Conclusions Our case highlights another pathomechanism for non-infective lung-disorders in alemtuzumab treated MS patients. DAD is a potential, albeit rare side effect of alemtuzumab, broadening the spectrum of non-infective lung disorders that should be considered in the diagnostic work-up.