Dimethyl fumarate

Dimethyl fumarate Reactions 1704, p139 - 2 Jun 2018 dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 1350 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for Lymphopenia: 5 case reports 12 months. The subsequent laboratory tests showed ALC, In a case series, five patients (one man and four women) WBC and absolute neutrophil count between 500–740 n/µL, aged 36 64 years were described, who developed prolonged 4200–5990 n/µL and 3100–3800 n/µL, respectively. At a lymphopenia during treatment with dimethyl fumarate [route 6-month follow-up, lymphopenia persisted. and dosage not stated; not all times to reaction onsets stated]. Author comment: "Lymphopenia was evaluated as a Case 1: This report describes a 36-year-old woman, who probable iatrogenic complication of [dimethyl fumarate]." developed lymphopenia during treatment with dimethyl "Haematological assessment excluded other causes of fumarate. The woman was diagnosed with relapsing-remitting lymphopenia, which was evaluated as a probable iatrogenic multiple sclerosis (RRMS) in 2001 at the age of 22-year and complication of [dimethyl fumarate]". "Five of these, including received treatment with interferon β-1a until a spinal relapse in the case above, showed prolonged lymphopenia after 2015. At the age of 36-year, she started receiving treatment [dimethyl fumarate] stop". with dimethyl fumarate. Four months after the start of dimethyl fumarate, she developed lymphopenia with low WBC Zecca C, et al. Severe multiple sclerosis reactivation during prolonged and absolute lymphocyte count (ALC), which led to cessation lymphopenia after dimethyl fumarate discontinuation. Acta Neurologica Scandinavica 137: 623-625, No. 6, Jun 2018. Available from: URL: http:// of dimethyl fumarate. Two weeks after the cessation of doi.org/10.1111/ane.12882 - Switzerland 803322987 dimethyl fumarate, ALC increased and dimethyl fumarate was restarted. However, laboratory tests in November 2015 showed recurrence of lymphopenia, which led to permanent cessation of dimethyl fumarate. She had received dimethyl fumarate for 8 months. Within four weeks after the permanent cessation of dimethyl fumarate, the WBC recovered. However, 9 9 the ALC fluctuated between 0.6 × 10 /L and 0.7 × 10 /L up to 6 months after the discontinuation of dimethyl fumarate (May 2016). Meanwhile, she presented with a new severe spinal relapse of RRMS. The confirmed diagnosis of lymphopenia was made involving T CD4+, T CD8+ with CD19+ and a comprehensive haematological assessment was given. Lymphopenia was considered to be a probable iatrogenic complication of dimethyl fumarate. She was treated with methylprednisolone for 3 days. After 6.5 months from the onset, lymphopenia resolved with an increased ALC and WBC. Case 2: This report describes a 64-year-old man, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 3800 n/µL. Eventually, he developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. He had received dimethyl fumarate for 20 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 470 770 n/µL, – – 3200 5800 n/µL and 2490 3870 n/µL, respectively. At a 6-month follow-up, lymphopenia persisted. Case 3: This report describes a 45-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 1149 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for 27 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 360 780 n/µL, – – 4300 9100 n/µL and 1960 7400 n/µL, respectively. At a 6-month follow-up, lymphopenia persisted. Case 4: This report describes a 43-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 2720 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for 12 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 460 730 n/µL, – – 2000 4700 n/µL and 1260 3360 n/µL, respectively. At an 11-month follow-up, lymphopenia persisted. Case 5: This report describes a 63-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Dimethyl fumarate

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46782-2
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Abstract

Reactions 1704, p139 - 2 Jun 2018 dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 1350 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for Lymphopenia: 5 case reports 12 months. The subsequent laboratory tests showed ALC, In a case series, five patients (one man and four women) WBC and absolute neutrophil count between 500–740 n/µL, aged 36 64 years were described, who developed prolonged 4200–5990 n/µL and 3100–3800 n/µL, respectively. At a lymphopenia during treatment with dimethyl fumarate [route 6-month follow-up, lymphopenia persisted. and dosage not stated; not all times to reaction onsets stated]. Author comment: "Lymphopenia was evaluated as a Case 1: This report describes a 36-year-old woman, who probable iatrogenic complication of [dimethyl fumarate]." developed lymphopenia during treatment with dimethyl "Haematological assessment excluded other causes of fumarate. The woman was diagnosed with relapsing-remitting lymphopenia, which was evaluated as a probable iatrogenic multiple sclerosis (RRMS) in 2001 at the age of 22-year and complication of [dimethyl fumarate]". "Five of these, including received treatment with interferon β-1a until a spinal relapse in the case above, showed prolonged lymphopenia after 2015. At the age of 36-year, she started receiving treatment [dimethyl fumarate] stop". with dimethyl fumarate. Four months after the start of dimethyl fumarate, she developed lymphopenia with low WBC Zecca C, et al. Severe multiple sclerosis reactivation during prolonged and absolute lymphocyte count (ALC), which led to cessation lymphopenia after dimethyl fumarate discontinuation. Acta Neurologica Scandinavica 137: 623-625, No. 6, Jun 2018. Available from: URL: http:// of dimethyl fumarate. Two weeks after the cessation of doi.org/10.1111/ane.12882 - Switzerland 803322987 dimethyl fumarate, ALC increased and dimethyl fumarate was restarted. However, laboratory tests in November 2015 showed recurrence of lymphopenia, which led to permanent cessation of dimethyl fumarate. She had received dimethyl fumarate for 8 months. Within four weeks after the permanent cessation of dimethyl fumarate, the WBC recovered. However, 9 9 the ALC fluctuated between 0.6 × 10 /L and 0.7 × 10 /L up to 6 months after the discontinuation of dimethyl fumarate (May 2016). Meanwhile, she presented with a new severe spinal relapse of RRMS. The confirmed diagnosis of lymphopenia was made involving T CD4+, T CD8+ with CD19+ and a comprehensive haematological assessment was given. Lymphopenia was considered to be a probable iatrogenic complication of dimethyl fumarate. She was treated with methylprednisolone for 3 days. After 6.5 months from the onset, lymphopenia resolved with an increased ALC and WBC. Case 2: This report describes a 64-year-old man, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 3800 n/µL. Eventually, he developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. He had received dimethyl fumarate for 20 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 470 770 n/µL, – – 3200 5800 n/µL and 2490 3870 n/µL, respectively. At a 6-month follow-up, lymphopenia persisted. Case 3: This report describes a 45-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 1149 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for 27 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 360 780 n/µL, – – 4300 9100 n/µL and 1960 7400 n/µL, respectively. At a 6-month follow-up, lymphopenia persisted. Case 4: This report describes a 43-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of dimethyl fumarate initiation, the absolute lymphocyte count (ALC) was 2720 n/µL. Eventually, she developed prolonged lymphopenia with low ALC, which led to discontinuation of dimethyl fumarate. She had received dimethyl fumarate for 12 months. The subsequent laboratory tests showed ALC, WBC and absolute neutrophil count between 460 730 n/µL, – – 2000 4700 n/µL and 1260 3360 n/µL, respectively. At an 11-month follow-up, lymphopenia persisted. Case 5: This report describes a 63-year-old woman, who developed lymphopenia during treatment with dimethyl fumarate. The man, who had multiple sclerosis, started receiving treatment with dimethyl fumarate. At the time of 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References

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