Abstract
Balo's concentric sclerosis (BCS) is a rare demyelinating disorder of the central nervous system. The humanised monoclonal antibody alemtuzumab has shown efficacy in another demyelinating disorder, relapsing-remitting multiple sclerosis. We aimed to explore its efficacy in treatment-refractory BCS. A 52-year-old male with radiologically confirmed progressive BCS resistant to steroids, plasmapharesis and cyclophosphamide was administered a standard protocol of alemtuzumab. Treatment failed to slow his decline; he died 6 months after administration. Why alemtuzumab induced no clinical or radiological impact may be multifactorial. We review the evidence directing BCS therapy and propose the next steps for exploring this potentially fatal condition.
Keywords:
Balo’s concentric sclerosis; Campath®; alemtuzumab; treatment.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Alemtuzumab
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Anti-Inflammatory Agents / therapeutic use
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Antibodies, Monoclonal, Humanized / therapeutic use*
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Brain / pathology
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Diffuse Cerebral Sclerosis of Schilder / drug therapy*
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Diffuse Cerebral Sclerosis of Schilder / pathology
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Diffuse Cerebral Sclerosis of Schilder / physiopathology
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Diffusion Magnetic Resonance Imaging
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Disease Progression
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Enteral Nutrition
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Fatal Outcome
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Humans
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Magnetic Resonance Imaging
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Male
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Methylprednisolone / therapeutic use
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Middle Aged
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Multiple Sclerosis, Relapsing-Remitting / drug therapy
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Muscle Weakness / etiology
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Neuroprotective Agents / therapeutic use*
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Pneumonia, Aspiration
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Treatment Failure
Substances
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Anti-Inflammatory Agents
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Antibodies, Monoclonal, Humanized
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Neuroprotective Agents
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Alemtuzumab
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Methylprednisolone