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Updated: May 3, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Ocrelizumab-associated cryptogenic organizing pneumonia in multiple sclerosis: Two case reports and comprehensive
Alessandro Gans1, Elena Pinuccia Verrengia1, Elisabetta Ricchiuti2
1Neurology and Stroke Unit, Department of Neuroscience, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy.
Background:
Cryptogenic organizing pneumonia (COP) is an interstitial lung disease, with causes including anti-CD20 antibodies. Ocrelizumab is a humanized monoclonal antibody against CD20 approved for use in relapsing-remitting or primary progressive multiple sclerosis (MS), with no conclusive data regarding pulmonary toxicity.
Cases:
We describe two cases of COP associated with ocrelizumab use in multiple sclerosis patients.
Conclusions:
We suggest considering COP whenever respiratory symptoms arise in MS patients receiving ocrelizumab therapy. COP diagnosis requires clinical and radiological exclusion of alternative diagnoses such as opportunistic infections, autoimmunity, drugs, and neoplasms. Appropriate steroid therapy has an excellent clinical response rate.
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