Multiple Sclerosis and MEN2 Neoplasia in a Female Patient: A Unique Co-Existence with Expanded Immunological Interest and Therapeutical Challenges, before and after Patient’s COVID-19 Infection
Nikolaos Markoglou,
George Simeakis,
Maria Alevizaki,
Georgios Velonakis,
Theofanis Chatzistamatiou,
Maria Spyropoulou-Vlachou,
Catherine Stavropoulos-Giokas,
Leonidas Stefanis,
Maria Anagnostouli
Affiliations
Nikolaos Markoglou
Research Immunogenetics Laboratory, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition University Hospital, 11528 Athens, Greece
George Simeakis
Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
Maria Alevizaki
Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
Georgios Velonakis
Research Unit of Radiology, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
Theofanis Chatzistamatiou
Histocompatibility & Immunogenetics Laboratory, Hellenic Cord Blood Bank, Biomedical Research Foundation, Academy of Athens, 11528 Athens, Greece
Maria Spyropoulou-Vlachou
Histocompatibility & Immunogenetics Laboratory, Hellenic Cord Blood Bank, Biomedical Research Foundation, Academy of Athens, 11528 Athens, Greece
Catherine Stavropoulos-Giokas
Histocompatibility & Immunogenetics Laboratory, Hellenic Cord Blood Bank, Biomedical Research Foundation, Academy of Athens, 11528 Athens, Greece
Leonidas Stefanis
1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition University Hospital, 11528 Athens, Greece
Maria Anagnostouli
Research Immunogenetics Laboratory, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition University Hospital, 11528 Athens, Greece
Multiple sclerosis (MS) and its various comorbidities that may be observed are of great interest due to the complexity of MS pathophysiology and all of the immunological changes that follow. The incidence of cancer in MS has been investigated for several years, as not only does it affect ongoing therapeutical decisions, but also, certain disease-modifying treatments (DMTs) may increase the risk of tumorigenesis. For the first time, we present a case of a female patient with pediatric-onset MS (POMS) and multiple endocrine neoplasia 2B (MEN2B) and analyze the immunological impact of these diseases on the therapeutical choice, under the umbrella of her COVID-19 infection and the SARS-CoV-2 pandemic as a whole. We also review the existing literature regarding the immunogenetic and immunological correlations between these two extremely rare diseases and discuss the most suitable treatment for our case, which seems to be an anti-CD20 agent due to a better outcome in putative MS worsening and tumor progression, when killer immunoglobulin-like receptors’ (KIR) expression is reduced in natural killer (NK) cells. We also broaden our concerns on this comorbidity issue, at the same time focusing on the future research needed in this unexplored field of the comorbidity of MS and cancers.
