According to ANCA Vasculitis News, recent research shows that patients with multiple sclerosis who are being treated with Lemtrada are at greater risk of developing severe ANCA vasculitis. The drug therapy previously caused autoimmune complications, highlighting a growing problem.
ANCA Vasculitis
As a whole, vasculitis is characterized by blood vessel inflammation, which restricts blood flow and leads to organ damage. Additionally, if vasculitis stretches the blood vessels, it can create an aneurysm, which causes severe and dangerous internal bleeding when burst. There is no definitive cause for vasculitis. However, scientists hypothesize that some cases stem from an immune reaction. Symptoms include fever, swelling, loss of appetite, fatigue, blood clots, sinus and pulmonary inflammation, mouth ulcers, joint pain, and rash. Learn more about vasculitis.
ANCA vasculitis is a subset of the condition. According to the UNC Kidney Center, ANCA vasculitis is considered a type of autoimmune vasculitis. ANCA stands for anti-neutrophilic cytoplasmic autoantibody. These ANCAs attack neutrophils, a type of white blood cells. As a result, these neutrophils then attack small blood vessels, causing inflammation.
Symptoms of ANCA vasculitis vary, but can include:
- Fever
- Joint and muscle pain
- Little to no appetite
- Unintended weight loss
- Tinnitus
- Peripheral neuropathy
- Bloody or foamy urine
- Loss of kidney function
- Shortness of breath
- A persistent cough, or coughing up blood
- Frequent sinus infections
- Changes in vision
- A rash
Lemtrada: An Overview
The study, published in Multiple Sclerosis Journal, examined how Lemtrada is frequently causing autoimmune issues in patients. The drug therapy treats patients with relapsing-remitting multiple sclerosis. It helps manage symptoms, reduce instances of relapse, and halt disease progression.
However, Lemtrada can cause some rare, and in some cases dangerous, adverse reactions. These include kidney damage, thyroid diseases, and idiopathic thrombocytopenic purpura. The latter is a blood disorder in which the immune system mistakenly attacks platelets, radically dropping the count.
ANCA Vasculitis & Multiple Sclerosis: A Case Study
This case study follows one 26-year-old patient with multiple sclerosis. He was treated with Lemtrada, but soon experienced severe vasculitis in multiple organs. It started with a fever and swelling of his ear cartilage. Antibiotics didn’t seem to help. Then, his condition progressed: pink eye, bleeding under the skin of his legs.
Next, the patient developed Graves’ disease, categorized by an overactive thyroid and the overproduction of thyroid hormones. If untreated, Graves’ disease can cause organ, bone, and muscle damage. A blood test also revealed heightened levels of ANCAs.
Doctors decided that they should wait to give the patient any more Lemtrada. Unfortunately, he still did not recover. Instead, his symptoms worsened and grew to include chest tightness and shortness of breath. He began to cough up blood. Testing showed high antibody levels and bleeding in his lungs. The diagnosis? ANCA vasculitis.
A combination treatment of plasma exchange, rituximab, and prednisone helped resolve his symptoms. But reducing the prednisone dose caused a vasculitis flare. Eventually, the patient needed to have surgery to completely remove his thyroid.
Therefore, patients with multiple sclerosis should be closely monitored on Lemtrada in case this reaction arises.
