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Multiple Sclerosis
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Erythema nodosum and glatiramer acetate treatment in relapsing-remitting multiple sclerosis

E. Thouvenot

Service de Neurologie, Hôpital Gui de Chauliac 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France

D. Hillaire-Buys

Service de Pharmacologie Médicale et Toxicologie, Hôpital Saint-Eloi, France

M.A. Bos-Thompson

Service de Pharmacologie Médicale et Toxicologie, Hôpital Saint-Eloi, France

V. Rigau

Service d'Anatomopathologie, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France

L. Durand

Service d'Anatomopathologie, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France

B. Guillot

Service de Dermatologie, Hôpital Saint-Eloi, France

W. Camu

Service de Neurologie, Hôpital Gui de Chauliac 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France, w-camu{at}chu-montpellier.fr

Glatiramer acetate (GA), a well tolerated immunomodulatory treatment for relapsing—remitting multiple sclerosis (RR-MS), consists of a 4-amino acid polymer that mimics the myelin basic protein (MBP). We report the first case of biopsy-proven erythema nodosum (EN) in a patient presenting RR-MS under GA treatment. Comprehensive exams were negative in the search of the etiology of EN, which spontaneously resolved despite treatment continuation. GA treatment is known to generate reactive polyclonal antibodies that can cross-react with myelin epitopes, like MBP. These antibodies may also be implicated in allergenic reactions and auto-immune adverse events, such as anaphylactic shock, lymphadenopathy, livedo-like dermatitis, or lymphocytic infiltration. EN is an unspecific skin reaction occurring in several disorders and induced by many treatments. As EN can result from a polyclonal antibody response or type I hypersensitivity mechanisms, we hypothesize that GA treatment could be responsible for the occurrence of EN. Multiple Sclerosis 2007; 13: 941—944. http://msj.sagepub.com

Key Words: erythema nodosum • Glatiramer acetate • multiple sclerosis • adverse drug reaction

Multiple Sclerosis, Vol. 13, No. 7, 941-944 (2007)
DOI: 10.1177/1352458507076385
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[Abstract] [Full Text] [PDF]


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