PMID- 32862038
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 46
DP  - 2020 Nov
TI  - A case report with tuberculous meningitis during fingolimod treatment.
PG  - 102450
LID - S2211-0348(20)30525-3 [pii]
LID - 10.1016/j.msard.2020.102450 [doi]
AB  - OBJECTIVE: We aimed to describe a case study of tuberculous meningitis in a 
      patient with multiple sclerosis (MS) receiving fingolimod. CASE REPORT: 
      A-Thirty-five-year-old woman with MS started interferon beta-1b treatment in 
      2016. Due to frequent relapses and disability accumulation, her treatment was 
      switched to fingolimod in 2018. The patient presented with subacute headache, 
      fever, confusion, nausea, and vomiting after one year of treatment with 
      fingolimod. Her cerebrospinal fluid (CSF) examination yielded a lymphocytic 
      pleocytosis, elevated protein level, and decreased glucose levels. Her brain 
      magnetic-resonance-images (MRI) showed contrast enhancement of meninges without 
      any new demyelinating lesions. Mycobacterium tuberculosis was isolated in her CSF 
      culture. After using anti-tuberculosis treatment for nine months, the patient's 
      infection resolved entirely without any disability related to meningitis. Then, 
      the fingolimod therapy was switched to glatiramer acetate. CONCLUSION: Herein, we 
      report the first case with fingolimod-associated meningitis during Mycobacterium 
      tuberculosis in a patient with MS. Clinicians should keep in mind that fingolimod 
      treatment may reactivate latent tuberculosis, especially in endemic regions.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Koseoglu, Mesrure
AU  - Koseoglu M
AD  - Department of Neurology, Bakirkoy Training and Research Hospital for Psychiatry 
      and Neurological Disorders, University of Health Sciences, Istanbul, Turkey. 
      Electronic address: meskose@yahoo.com.
FAU - Gozubatik Celik, Rabia Gokcen
AU  - Gozubatik Celik RG
AD  - Department of Neurology, Bakirkoy Training and Research Hospital for Psychiatry 
      and Neurological Disorders, University of Health Sciences, Istanbul, Turkey. 
      Electronic address: gokcen3@hotmail.com.
FAU - Kurtuncu, Murat
AU  - Kurtuncu M
AD  - Department of Neurology, Istanbul Faculty of Medicine Istanbul University, 
      Istanbul, Turkey. Electronic address: murat.kurtuncu@istanbul.edu.tr.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200815
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - 145155-23-3 (Interferon beta-1b)
RN  - 5M691HL4BO (Glatiramer Acetate)
RN  - G926EC510T (Fingolimod Hydrochloride)
SB  - IM
MH  - Female
MH  - Fingolimod Hydrochloride/adverse effects
MH  - Glatiramer Acetate
MH  - Humans
MH  - Interferon beta-1b
MH  - *Multiple Sclerosis
MH  - *Tuberculosis, Meningeal/drug therapy
OTO - NOTNLM
OT  - Fingolimod
OT  - Meningitis
OT  - Multiple sclerosis
OT  - Tuberculosis
EDAT- 2020/08/31 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/08/31 06:00
PHST- 2020/05/06 00:00 [received]
PHST- 2020/08/04 00:00 [revised]
PHST- 2020/08/12 00:00 [accepted]
PHST- 2020/08/31 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/08/31 06:00 [entrez]
AID - S2211-0348(20)30525-3 [pii]
AID - 10.1016/j.msard.2020.102450 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2020 Nov;46:102450. doi: 10.1016/j.msard.2020.102450. 
      Epub 2020 Aug 15.