Highlights
- •Implications of Multiple Sclerosis associated with other immune-mediated diseases are rarely discussed.
- •Rituximab stabilized disease activity in a patient with Multiple Sclerosis and Hypocomplementemic Urticarial Vasculitis.
- •More reports are needed to help clarify the best approach in Multiple Sclerosis with concurrent autoimmune diseases.
Abstract
Background
Multiple Sclerosis (MS) has been associated with several immune-mediated diseases
but the mechanisms that explain such associations, as well as their implications in
clinical practice and treatment are rarely discussed.
Case presentation
We report the case of a patient with a history of MS since she was 27 years old, followed
by a diagnosis of Hypocomplementemic Urticarial Vasculitis (HUV) seven years later.
Several disease-modifying treatments for MS and HUV were used but with limited benefit
in both diseases and significant MS progression. Activity of both diseases was later
stabilized with Rituximab. We discuss the hypotheses of a central nervous system involvement
in urticarial vasculitis or an association between MS and HUV, and examine the challenges
in their management.
Conclusions
In the presence of concurrent immune-mediated diseases, the diagnosis of MS can be
challenging. This clinical presentation posed significant difficulties in disease
management, influencing therapeutic options and their effectiveness/adverse effects
profile. The best approach in MS patients with concurrent autoimmune diseases remains
to be established and more reports are needed to help clarify this subject.
Keywords
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References
- Utilization of dimethyl fumarate and related molecules for treatment of multiple sclerosis, cancer, and other diseases.Front. Immunol. 2016; 7: 278
- Cutaneous adverse events associated with disease-modifying treatment in multiple sclerosis: a systematic review.Mult. Scler. 2012; 18: 1705-1717
- Hypocomplementemic urticarial vasculitis syndrome: a case report and literature review.J. Clin. Aesthet. Dermatol. 2012; 5: 36-46
- Disease modifying therapies use associated with comorbid autoimmune diseases in multiple sclerosis patients.Mult. Scler. Relat. Disord. 2015; 4: 228-233
- The clinical spectrum and therapeutic management of hypocomplementemic urticarial vasculitis: data from a French nationwide study of fifty-seven patients.Arthritis Rheumatol. 2015; 67: 527-534
- A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis.Mult. Scler. 2015; 21: 282-293
- Comparing the efficacy of disease-modifying therapies in multiple sclerosis.Mult. Scler. Relat. Disord. 2017; 18: 109-116
Article info
Publication history
Published online: February 15, 2019
Accepted:
February 13,
2019
Received in revised form:
February 4,
2019
Received:
October 30,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
