@article{2996959,
    title = "IgG4-related autoimmune manifestations in Alemtuzumab-treated multiple sclerosis patients",
    author = "Vakrakou, A.G. and Tzanetakos, D. and Evangelopoulos, M.-E. and Fragoulis, G.E. and Kazakou, P. and Lekka, E. and Kafasi, N. and Tzartos, J.S. and Andreadou, E. and Koutsis, G. and Gialafos, E. and Dimitrakopoulos, A. and Zampeli, E. and Rontogianni, D. and Theocharis, S. and Zapanti, E. and Stathopoulos, P.-A. and Anagnostouli, M. and Stefanis, L. and Kilidireas, C.",
    journal = "Journal of Neuroimmunology",
    year = "2021",
    volume = "361",
    publisher = "Elsevier B.V.",
    issn = "0165-5728",
    doi = "10.1016/j.jneuroim.2021.577759",
    keywords = "alemtuzumab;  autoantibody;  biological marker;  complement;  immunoglobulin G, adult;  blood;  etiology;  female;  Graves disease;  human;  immune reconstitution;  immunology;  lymphocyte count;  male;  multiple sclerosis;  neurologic disease;  retrospective study;  young adult, Adult;  Alemtuzumab;  Autoantibodies;  Autoimmune Diseases of the Nervous System;  Biomarkers;  Complement System Proteins;  Female;  Graves Disease;  Humans;  Immune Reconstitution;  Immunoglobulin G;  Infections;  Lymphocyte Count;  Male;  Multiple Sclerosis, Relapsing-Remitting;  Retrospective Studies;  Young Adult",
    abstract = "We aimed to determine whether Alemtuzumab-induced immune reconstitution affects immunoglobulin and complement levels in the serum of Relapsing-Remitting Multiple Sclerosis (RRMS) patients. IgG4-levels were increased 24-months after treatment initiation compared to baseline levels in twenty-nine patients. Alemtuzumab-treated patients with the highest IgG4-levels were more prone to thyroid-related autoimmune manifestations and specific autoimmune adverse events such as Crohn's disease, Graves' disease, and hemolytic anemia. Compared to baseline, total IgG-levels showed a trend towards reduced levels following two-courses of Alemtuzumab, but no significant change of C3 and/or C4-levels was observed. In conclusion, monitoring of IgG4-levels can serve as a marker for secondary autoimmunity risk in multiple sclerosis patients treated with Alemtuzumab. © 2021 Elsevier B.V."
}