Abstract
Primary biliary cirrhosis (PBC) and multiple sclerosis (MS) are considered autoimmune diseases with a multifactorial aetiology which is thought to be due to a combination of genetic predisposition and environmental triggers. An association of both diseases has been previously described in sporadic case reports. Fingolimod, an antagonist of the sphingosine 1 phosphate receptor family (S1P1/3/4/5), is a promising and effective drug in the treatment of MS. Here we describe a case of PBC like syndrome that was unmasked, concomitantly or consequently to Epstein Barr virus (EBV) infection reactivation, in a 34 year old male patient with relapsing remitting multiple sclerosis who was receiving fingolimod treatment.
MeSH terms
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Adult
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Cholagogues and Choleretics / therapeutic use
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Epstein-Barr Virus Infections / complications*
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Fingolimod Hydrochloride / administration & dosage
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Fingolimod Hydrochloride / adverse effects*
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Herpesvirus 4, Human / immunology
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Humans
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Immunocompromised Host*
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / adverse effects*
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Liver Cirrhosis, Biliary / complications*
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Liver Cirrhosis, Biliary / drug therapy
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Male
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Multiple Sclerosis / complications*
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Multiple Sclerosis / drug therapy*
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Recurrence
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Treatment Outcome
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Ursodeoxycholic Acid / therapeutic use
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Withholding Treatment
Substances
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Cholagogues and Choleretics
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Immunosuppressive Agents
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Ursodeoxycholic Acid
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Fingolimod Hydrochloride