Increased risk of disseminated cryptococcal infection in a patient with multiple sclerosis on fingolimod

IDCases

Alana Lewis¹  Abdul Basit²  Pushpinder Kaur²  Nikolas St Cyr²  Zaman Muhammad² 

[1] Corresponding author at: Internal Medicine, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY, 11235, USA.;Department of Internal Medicine, Coney Island Hospital, Brooklyn, USA;

关键词: Multiple sclerosis;    Fingolimod;    Disseminated cryptococcal;    Varicella zoster virus;   

DOI  :  

来源: DOAJ

【 摘 要 】

Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an estimated 2.3 million people being affected globally, and is a major cause of permanent disability. About 90 % of the affected patients with MS have relapsing-remitting type. Fingolimod became the first FDA approved oral drug in 2010 with an immunomodulating mechanism to control the relapse rates. However, since its introduction, increased cases of cryptococcal infections have been reported including meningoencephalitis and disseminated infections. Herein, we present the case of a 34-year-old-male with disseminated Cryptococcal and localized varicella zoster virus (VZV) coinfection to highlight the risk of opportunistic infections associated with the long-term use of fingolimod. The objective of this literature review is for clinicians to have a high index of suspicion for cryptococcal infections when dealing with MS patients on Fingolimod, especially those who present with neurological symptoms, as this mimics MS relapse.

【 授权许可】

Unknown