Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study

Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study

Although pregnancy is potentially protective against relapses of multiple sclerosis, severe rebound of disease activity after withdrawal of fingolimod may occur. We report a woman with multiple sclerosis who discontinued fingolimod in the first month of her pregnancy. She developed severe disease re...

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Main Authors: Beatriz Canibaño, Musab Ali, Boulenouar Mesraoua, Gayane Melikyan, Hasan Al Hail, Faiza Ibrahim, Yolande Hanssens, Dirk Deleu
Format: Article
Language:English
Published: Elsevier 2020-01-01
Series:Case Reports in Women's Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2214911219301432
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spelling doaj-12f813e89c434949a8d3f4fc1387d1062020-11-24T20:52:13ZengElsevierCase Reports in Women's Health2214-91122020-01-0125Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case studyBeatriz Canibaño0Musab Ali1Boulenouar Mesraoua2Gayane Melikyan3Hasan Al Hail4Faiza Ibrahim5Yolande Hanssens6Dirk Deleu7Departments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarClinical Services Unit, Pharmacy, Hamad Medical Corporation, P.O. Box 3050, Doha, QatarDepartments of Neurology, Neuroscience Institute, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar; Corresponding author.Although pregnancy is potentially protective against relapses of multiple sclerosis, severe rebound of disease activity after withdrawal of fingolimod may occur. We report a woman with multiple sclerosis who discontinued fingolimod in the first month of her pregnancy. She developed severe disease rebound which responded poorly to steroids. She was started on rituximab, which was continued during the rest of her pregnancy and beyond. Rituximab appeared safe and well tolerated by both mother and infant, and could be considered in pregnancy for those patients with multiple sclerosis who are at high risk of gestational and postpartum relapse. Keywords: Multiple sclerosis, Pregnancy, Rituximab, Fingolimod, Reboundhttp://www.sciencedirect.com/science/article/pii/S2214911219301432
collection DOAJ
language English
format Article
sources DOAJ
author Beatriz Canibaño
Musab Ali
Boulenouar Mesraoua
Gayane Melikyan
Hasan Al Hail
Faiza Ibrahim
Yolande Hanssens
Dirk Deleu
spellingShingle Beatriz Canibaño
Musab Ali
Boulenouar Mesraoua
Gayane Melikyan
Hasan Al Hail
Faiza Ibrahim
Yolande Hanssens
Dirk Deleu
Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
Case Reports in Women's Health
author_facet Beatriz Canibaño
Musab Ali
Boulenouar Mesraoua
Gayane Melikyan
Hasan Al Hail
Faiza Ibrahim
Yolande Hanssens
Dirk Deleu
author_sort Beatriz Canibaño
title Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
title_short Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
title_full Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
title_fullStr Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
title_full_unstemmed Severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: A case study
title_sort severe rebound disease activity after fingolimod withdrawal in a pregnant woman with multiple sclerosis managed with rituximab: a case study
publisher Elsevier
series Case Reports in Women's Health
issn 2214-9112
publishDate 2020-01-01
description Although pregnancy is potentially protective against relapses of multiple sclerosis, severe rebound of disease activity after withdrawal of fingolimod may occur. We report a woman with multiple sclerosis who discontinued fingolimod in the first month of her pregnancy. She developed severe disease rebound which responded poorly to steroids. She was started on rituximab, which was continued during the rest of her pregnancy and beyond. Rituximab appeared safe and well tolerated by both mother and infant, and could be considered in pregnancy for those patients with multiple sclerosis who are at high risk of gestational and postpartum relapse. Keywords: Multiple sclerosis, Pregnancy, Rituximab, Fingolimod, Rebound
url http://www.sciencedirect.com/science/article/pii/S2214911219301432
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AT boulenouarmesraoua severerebounddiseaseactivityafterfingolimodwithdrawalinapregnantwomanwithmultiplesclerosismanagedwithrituximabacasestudy
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