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Research Letter
April 8, 2019

Fulminant Hepatitis Associated With Echovirus 25 During Treatment With Ocrelizumab for Multiple Sclerosis

Author Affiliations
  • 1Department of Health Sciences, University of Genoa, Genoa, Italy
  • 2Infectious Diseases Unit, Ospedale Policlinico San Martino–Istituto Di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
  • 3Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
  • 4Ospedale Policlinico San Martino–Istituto Di Ricovero e Cura a Carattere Scientifico, Genoa, Italy
JAMA Neurol. 2019;76(7):866-867. doi:10.1001/jamaneurol.2019.0522

Ocrelizumab (Ocrevus [Roche-Genentech]), a second-generation humanized anti-CD20 antibody, has been recently approved for multiple sclerosis (MS). Echoviruses and other enteroviruses have been associated with life-threatening infections in patients receiving anti-CD20 antibodies other than ocrelizumab.1-4 In this case study, we report a case of fulminant echovirus 25–associated hepatitis in a patient with relapsing-remitting MS who received ocrelizumab monotherapy.

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