IgG4-related autoimmune manifestations in Alemtuzumab-treated multiple sclerosis patients

Authors :: Vakrakou, A.G. Tzanetakos, D. Evangelopoulos, M.-E. Fragoulis, G.E. Kazakou, P. Lekka, E. Kafasi, N. Tzartos, J.S. Andreadou, E. Koutsis, G. Gialafos, E. Dimitrakopoulos, A. Zampeli, E. Rontogianni, D. Theocharis, S. Zapanti, E. Stathopoulos, P.-A. Anagnostouli, M. Stefanis, L. Kilidireas, C.
Publication Year :: 2021
Abstract: We aimed to determine whether Alemtuzumab-induced immune reconstitution affects immunoglobulin and complement levels in the serum of Relapsing-Remitting Multiple Sclerosis (RRMS) patients. IgG4-levels were increased 24-months after treatment initiation compared to baseline levels in twenty-nine patients. Alemtuzumab-treated patients with the highest IgG4-levels were more prone to thyroid-related autoimmune manifestations and specific autoimmune adverse events such as Crohn's disease, Graves' disease, and hemolytic anemia. Compared to baseline, total IgG-levels showed a trend towards reduced levels following two-courses of Alemtuzumab, but no significant change of C3 and/or C4-levels was observed. In conclusion, monitoring of IgG4-levels can serve as a marker for secondary autoimmunity risk in multiple sclerosis patients treated with Alemtuzumab. © 2021 Elsevier B.V.

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