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Myelin Oligodendrocyte Glycoprotein MOG35-55 Induced Experimental Autoimmune Encephalomyelitis EAE in C57BL/6 Mice
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Neoehrlichiosis associated with ocrelizumab in a patient with multiple sclerosis: A case report

Raja Majid Afzal1, Jeppe Romme Christensen2, Rosa Maja Møhring Gynthersen1

  • 1Department of Infectious Diseases, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|March 1, 2024
PubMed
Abstract

Insights

This case study reports the first probable instance of Neoehrlichia mikurensis infection in a multiple sclerosis patient undergoing ocrelizumab treatment. Early antibiotic intervention led to symptom resolution, highlighting the need for clinical awareness.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Neurology

Background:

  • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • Ocrelizumab is a CD20-depleting antibody used for treating MS, which can increase susceptibility to opportunistic infections.
  • Neoehrlichiosis is an emerging tick-borne bacterial infection caused by Neoehrlichia mikurensis.

Observation:

  • A patient with MS treated with ocrelizumab developed a prolonged clinical illness over several months.
  • The patient was ultimately diagnosed with neoehrlichiosis, a rare opportunistic infection.

Findings:

  • The diagnosis of neoehrlichiosis was confirmed in the MS patient on ocrelizumab therapy.
  • Symptoms of neoehrlichiosis began to resolve within days of initiating antibiotic treatment.

Implications:

  • This case represents the first probable instance of ocrelizumab-associated neoehrlichiosis in an MS patient.
  • Clinicians must consider neoehrlichiosis in patients with MS on CD20-depleting therapies, as it can be severe and life-threatening.
  • Awareness of this infection is crucial for timely diagnosis and management in immunocompromised patients.
Keywords:
B-cell depleting therapyMultiple sclerosisimmunodeficiencyinfectionneoerhlichiosisocrelizumab

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