MS Speaks

tumefaction - the process of tumefying; the organic process whereby tissue becomes swollen by the accumulation of fluid within it [Free Online Dictionary]

From PubMed, December 24, 2013:

Neurology. 2013 Nov 5;81(19):1654-8.

Tumefactive MS lesions under fingolimod: a case report and literature review

Pilz G, Harrer A, Wipfler P, Oppermann K, Sellner J, Fazekas F, Trinka E, Kraus J.

Author information

From the Department of Neurology (G.P., A.H., P.W., K.O., J.S., E.T., J.K.), Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria; the Department of Neurology (J.S.), Klinikum rechts der Isar, Technische Universität München, Germany; and the Department of Neurology (F.F.), Medical University of Graz, Austria.

OBJECTIVE:

To report about a possible association between fingolimod treatment and tumefactive demyelinating lesions (TDL) as seen in a patient developing repeated TDL on continued fingolimod therapy.

METHODS:

We performed serial clinical and radiologic assessments and immunophenotyping of blood and CSF immune cells. We also present a literature review about recent similar cases.

RESULTS:

Clinical course and radiologic findings were consistent with diagnosis of TDL. Immune cell phenotyping showed pronounced shifts in the immune cell composition related to fingolimod treatment. In addition, we observed a subset of highly differentiated effector cells (CD45R0negCCR7neg) within the CD8+ T-cell population, which was about 2-fold enriched in the CSF compared to the peripheral blood.

CONCLUSION:

Our observations add further evidence for the development of atypical demyelinating lesions in some patients receiving fingolimod. These might be related to a treatment-associated shift in the immunopathology of specifically susceptible individuals.

PMID: 24097813

The abstract can be seen here.