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Hidden relationship between fingolimod and bleeding: Possible novel management of fingolimod-associated lymphopenia by Hanazono, Akira; Sanpei, Yui; Kamada, Sachiko; Sugawara, Masashiro; Iijima, Katsunori is a Medicine article available to read on EtoBox.

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Fingolimod, a functional antagonist of sphingosine-1 phosphate receptor, is a disease modifying drug of multiple sclerosis and its remarkable adverse effect is peripheral lymphopenia because the drug retains lymphocyte in the secondary lymphoid tissues. Therefore, in theory, when severe bleedings occurred, the fingolimod-treated patients could not compensate for the loss of lymphocytes induced by bleedings because of the retention in the secondary lymphoid tissues. In addition, because most of the fingolimod is reported to be distributed in the erythrocytes, and the erythrocytes are the main regulator of serum sphingosine-1 phosphate concentration, bleeding may also affect metabolism of fingolimod and prognosis of multiple sclerosis. However, no study had focused the relationship between fingolimod and bleedings in multiple sclerosis. We encountered the first case in which fingolimod-associated lymphopenia worsened synchronously with gynecological bleeding, and was improved by the bleeding prophylaxis, uterine myomectomy. This case had statistically significant positive correlation between the serum hemoglobin level and peripheral lymphocyte count (P = 0.0000000507). We then had th

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Author

Hanazono, Akira; Sanpei, Yui; Kamada, Sachiko; Sugawara, Masashiro; Iijima, Katsunori

Publisher

Elsevier Science; Elsevier ; Churchill Livingstone; Elsevier BV (ISSN 0306-9877)

Published

2020

Language

EN

Field

Medicine (Life Sciences)