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Koska, Valeria; Förster, Moritz; Brouzou, Katja; Hatami, Maryam; Arat, Ercan; Aytulun, Ahmet; Albrecht, Philipp; Aktas, Orhan; Küry, Patrick; Meuth, Sven G.; Kremer, David
Frontiers in neurology, 06/2021, Letnik: 12Journal Article
The Marburg variant of multiple sclerosis (Marburg MS) is the most aggressive form of MS, often leading to death soon after onset. Here we describe the case of a 26-year-old Marburg MS patient presenting with severe neurological deficits requiring intensive care. In spite of more than 100 gadolinium-enhancing MRI lesions, the patient recovered almost completely upon high-dose cyclophosphamide (HiCy) rescue treatment (four consecutive days with 50 mg/kg/day, cumulative absolute dose of 14 g). Following the acute treatment, her disease was stabilized by B cell depletion using ocrelizumab. Clinical amelioration was reflected by a decrease of MRI activity and a marked decline of serum neurofilament light chain levels. HiCy rescue treatment followed by ocrelizumab as a maintenance therapy prevented permanent disability and achieved an almost complete clinical and drastic radiological improvement in this Marburg MS patient.
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in: SICRIS
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