Therapeutic Advances in Neurological Disorders (Oct 2022)

Alemtuzumab-induced alopecia universalis and transient accommodation spasm in a patient with multiple sclerosis

  • Dimitrios Tzanetakos,
  • Marianthi Breza,
  • John S. Tzartos,
  • Georgios Bontzos,
  • Aigli G. Vakrakou,
  • Alexandros Dermentzoglou,
  • Ilias Gkizis,
  • Georgios Smoustopoulos,
  • Maria-Eleptheria Evangelopoulos,
  • Leonidas Stefanis,
  • Costantinos Kilidireas

DOI
https://doi.org/10.1177/17562864221127476
Journal volume & issue
Vol. 15

Abstract

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Herein, we report a case of alopecia universalis and transient accommodation spasm presented after alemtuzumab administration in a patient previously treated with fingolimod. To the best of our knowledge, this is the first report of accommodation spasm as an acute adverse effect of alemtuzumab. Treatment with alemtuzumab in relapsing-remitting multiple sclerosis has been identified as a risk factor for developing secondary autoimmunity within the follow-up period (peak 18–36 months from the first infusion) such as thyroid disorders. This case highlights the need for postmarketing surveillance and the significance of reporting rare side effects related to alemtuzumab; its high efficacy should be weighted with potentially severe adverse events when making a therapeutic decision. Further studies in larger cohorts are needed to elucidate pathomechanisms of alemtuzumab.