MS Speaks

Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in relapsing-remitting multiple sclerosis patients on high-dose interferon β

Catherine Larochelle1,2
François Grand’maison3
Gilles P Bernier2
Mathieu Latour4
Jean-François Cailhier5
Alexandre Prat1,2

1Neuroimmunology Research Laboratory, Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Canada
2Department of Neurology, Université de Montréal, Canada
3Department of Neurology, Université de Sherbrooke, Canada
4Department of Pathology, Université de Montréal, Canada
5Department of Medicine, Université de Montréal, Canada
Alexandre Prat, Department of Medicine (Neurology), Université de Montréal, CRCHUM, 900 Rue Saint-Denis, Tour Viger, R09-412, Montreal, Qc, H2X OA9, Canada. Email: a.prat@umontreal.ca


Three women aged 34–47 years old, on high dose interferon beta-1a for relapsing–remitting multiple sclerosis, were hospitalized between 2009–2012 for thrombotic thrombocytopenic purpura-hemolytic uremic syndrome.

Patients sought medical attention for neurological symptoms including cephalalgia, blurred vision, confusion, focal deficits and seizures. All patients presented thrombocytopenia, hemolytic anemia and arterial hypertension. Despite plasma exchanges, corticosteroids and anti-CD20 treatments, all patients progressed towards severe renal insufficiency and one patient died of hemorrhagic shock.

In this report we identify a rare but morbid complication of interferon beta-1a treatment associated with female gender, Caucasian background and low body mass index.