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SYSTEMIC LUPUS ERYTHEMATOSUS AND SECONDARY SJÖGREN’S SYNDROME FOLLOWING TREATMENT WITH ALEMTUZUMAB FOR MULTIPLE SCLEROSIS: CASE REPORT

IPEK GUNGOR DOGAN, SEDA KUTLUG AGACKİRAN, BERİL TASDELEN, DAMLA CETİNKAYA TEZER, SERKAN DEMİR

Journal of Multiple Sclerosis Research - 2025;5(1):23-25

University of Health Sciences Turkiye, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Clinic of Neurology, Istanbul, Turkiye

 

Alemtuzumab, a humanized monoclonal antibody that targets CD52, is a potent treatment for relapsing-remitting multiple sclerosis (RRMS). Despite its efficacy, alemtuzumab can trigger secondary autoimmune disorders, which most commonly involve the thyroid and hematologic systems. Herein, we have presented the case of a 36-year-old woman with highly active RRMS who developed a rare presentation of systemic lupus erythematosus (SLE) and secondary Sjögren’s syndrome (sSS) 42 months after her last alemtuzumab infusion. While cases of SLE following alemtuzumab administration are extremely rare, the development of Sjögren’s syndrome (SS) in this context is previously unreported. The patient exhibited pancytopenia, proteinuria, autoimmune marker positivity (anti-nuclear, anti-double stranded DNA, anti-Sjögren’s syndrome type A), and low complement levels. leading to the SLE and sSS diagnoses and treated with corticosteroids, hydroxychloroquine, mycophenolate mofetil, and tacrolimus. This case underscores the importance of monitoring alemtuzumab-treated patients for delayed autoimmune complications and highlights the potential role of B and T cell dysregulation in secondary autoimmunity. Further research is necessary to elucidate the mechanisms underlying these rare adverse events.