[Alemtuzumab-induced Graves' disease]

Area of Science:

• Immunology
• Neurology
• Endocrinology

Background:

• Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease impacting the central nervous system.
• Alemtuzumab, a disease-modifying therapy (DMT), targets CD52+ cells, altering immune cell recruitment.
• Alemtuzumab treatment can lead to secondary autoimmune disorders, frequently involving the thyroid gland, such as Graves' disease (GD).

Observation:

• A clinical case involving a patient with MS treated with alemtuzumab is presented.
• The patient developed Graves' disease (GD) after alemtuzumab therapy.
• The patient experienced a relapse of thyrotoxicosis despite prior anti-thyroid drug treatment.

Findings:

• The patient was referred for radioiodine therapy (RAIT) for persistent thyrotoxicosis.
• Successful radioiodine therapy achieved the treatment goal within two months.
• Thyroid function was compensated with subsequent thyroid hormone therapy.

Implications:

• This case highlights the risk of secondary autoimmunity, specifically Graves' disease, following alemtuzumab treatment for MS.
• Radioiodine therapy is an effective treatment option for managing Graves' disease in patients with a history of MS and alemtuzumab use.
• Understanding and managing these secondary autoimmune complications is crucial for comprehensive patient care in MS management.