ArticleNeurology(R) neuroimmunology & neuroinflammation2026
Enterovirus Encephalitis in People With Multiple Sclerosis on Ocrelizumab: Insights From a Multicenter Case Series.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Anti-CD20 associated enterovirus meningoencephalitis: A narrative review with two illustrative cases.Multiple sclerosis journal - experimental, translational and clinicalReview
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAnti-CD20 therapies for multiple sclerosis (MS) are highly effective at preventing disease activity. Recognizing infectious complications of these therapies is essential.
methodsThree MS centers shared deidentified clinical data on persons with MS (pwMS) receiving ocrelizumab who developed enterovirus encephalitis.
resultsFive pwMS (4 with relapsing-remitting MS, 1 with secondary progressive MS) on ocrelizumab were identified. At diagnosis, the median age was 34 years (range, 30-57), the median MS duration was 5 years (range, 2-13), and the median ocrelizumab exposure was 3 years (range, 2-7). Four had young children who were recently ill, including 2 with hand, foot, and mouth disease. MRI brain revealed new nonenhancing T2 hyperintensities in the thalamus (2), substantia nigra (2), cerebellum (2), and pons (1). All had CSF pleocytosis (median, 57/mcL; range, 33-175). Enterovirus was detected by reverse-transcription PCR in CSF (4) and blood (2). Hypogammaglobulinemia was present in 4 patients tested; 1 also had neutropenia. Three received IV immunoglobulin. At follow-up (median, 7 months; range, 3-15), 1 patient had fully recovered and 4 had residual symptoms (cognitive, 1; gait impairment, 3). DISCUSSION: Enterovirus encephalitis is a rare but serious complication in pwMS receiving ocrelizumab; hypogammaglobulinemia may increase risk. Clinician awareness and prompt testing may improve outcomes.
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