Alemtuzumab is an approved und well known Medication for the treatment of multiple sclerosis and it is a humanized anti-CD52 monoclonal antibody. Autoimmune diseases are the most common side effect of Alemtuzumab treatment. In our Case is after 18 Months of Alemtuzumab therapy a thyroid autoimmune disease developed. Patient with multiple sclerosis during the normal Follow up appear increased thyroid antibodies TPO 101 KU/L (normal <34) and TRAK 38.2 IU/L (normal <1.75). The Patient is clinically symptom free and the thyroid function shows a heavy hypothyroidism with TSH 48.9 μIU/ml (0.274.2), FT4 5.52 ng/l (9.317) and FT3 1.58 pg/ml (2.04.4). Thyroid sonography showed a normal Thyroid. After therapy with Levothyroxin 75 μg was a euthyroidism achieved. The antibodies ware declining with TPO normal und TRAK 12.2 after 6 Months. Patient is unter regularly follow up. Contrary to published literature, we recorded a delayed autoimmune thyroid disease with all thyroid antibodies increased and a clinical hypothyroidism. Furthermore has be shown that Alemtuzumab caused an immune reaction but also modify the function of the antibodies and that is why we have hypothyroidism with TRAK antibodies. We suggest a long follow up for patients with Alemtuzumab therapy for the delayed side effects. The presence of Antibodies does not insure the same function of the antibodies which should be controlled.
18 - 21 May 2019
European Society of Endocrinology