TITLE:
Severe Anaemia during Natalizumab Treatment: Case Presentation with Literature Review
AUTHORS:
Siham Bouchal, Naoual Oubelkacem, Nabila Lahmadi, Rhizlane Berradi, Faouzi Belahsen
KEYWORDS:
Anaemia, Erythroblasts, Haematological Monitoring, Multiple Sclerosis, Natalizumab
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.11 No.3,
March
22,
2022
ABSTRACT: Progressive multifocal leukoencephalopathy is the most common serious complication related to natalizumab. However, serious haematological complications are very uncommon during treatment with natalizumab. Here we reported the case of an 18-year-old man with a 4-year history of relapsing-re- mitting multiple sclerosis. He was treated firstly by Teriflunomide for 1 year, but he presented relapses and his MRI shows new contrast-enhancing lesions. Therefore, we decided to switch from Teriflunomide to Natalizumab. The patient presented with profound anaemia after the 16th infusions treatment with Natalizumab. The patient’s hemoglobin was 3.2 g/dL with a lower blood reticulocyte value. After red cell transfusions and cessation of Natalizumab, anaemia resolved. Natalizumab was changed by an anti-CD20 monoclonal antibody. The patient had a stable course of multiple sclerosis at 13 months after initiation of Rituximab. We should alert clinicians to be aware of the possibility of anaemia during treatment by Natalizumab.