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Severe Late-Onset Neutropenia in a Pregnant Patient with Multiple Sclerosis after Ocrelizumab
Casey J Fealko1, Morgan N Rolon-Newton1, Marisa J L Aitken1,2
1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Introduction:
Ocrelizumab is a recombinant humanized anti-CD20 monoclonal antibody used to treat multiple sclerosis. Late-onset neutropenia, absolute neutrophil count <1.5 × 109/L that develops >4 weeks after last drug administration, is a known adverse event associated with anti-CD20 monoclonal antibodies, including rituximab and ocrelizumab.
Case Presentation:
We present the case of a 27-year-old woman who developed severe late-onset neutropenia during her third trimester of pregnancy after treatment with ocrelizumab 6 months prior.
Conclusion:
Neurologists should be aware of this risk and consider additional hematologic monitoring for pregnant patients who received anti-CD20 therapy as therapies such as G-CSF are available to help prevent serious infections.
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