Alemtuzumab (ALZ) is an anti-CD52 monoclonal antibody used to treat recurrent remittent multiple sclerosis (RRMS). After ALZ infusion, there is a depletion of T and B cells expressing CD52, while the stem cells and innate immune cells are spared. Longitudinal studies with long periods of follow-ups have reported ALZ-associated autoimmune diseases, such as thrombocytopenic purpura and thyroiditis. We report two patients who developed autoimmune hemophilia A or acquired hemophilia (AHA) after ALZ infusion, one of whom developed severe vitiligo. To the best of our knowledge, these two cases of ALZ-associated AHA are the first two cases to be reported in Brazil, and the fourth and fifth AHA cases to be reported worldwide. AHA is a potential life-threatening disease if not diagnosed and treated in a timely manner. The development of AHA should be cited as a possible adverse event, and specific coagulation tests must be part of the official recommendations for patient follow-ups.

译文

Alemtuzumab (ALZ) 是一种anti-CD52单克隆抗体,用于治疗复发性缓解多发性硬化症 (RRMS)。ALZ输注后,表达CD52的T和b细胞耗竭,而干细胞和先天免疫细胞则得以幸免。长期随访的纵向研究报告了与ALZ相关的自身免疫性疾病,例如血小板减少性紫癜和甲状腺炎。我们报告了两名在输注ALZ后发展为自身免疫性血友病A或获得性血友病 (AHA) 的患者,其中一名患者发展为严重白癜风。据我们所知,这两个与ALZ相关的AHA病例是巴西报告的前两个病例,也是全球报告的第四和第五个AHA病例。如果不及时诊断和治疗,AHA是一种潜在的威胁生命的疾病。AHA的发展应被认为是可能的不良事件,并且特定的凝血测试必须是患者随访的官方建议的一部分。

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