Graves’ disease following commencement of alemtuzumab therapy: a case report discussing clinical considerations and possible pathophysiology

BACKGROUND Monoclonal antibodies have become a mainstay in the treatment of autoimmune, viral and malignant disease. Many adverse reactions to antibody therapy are unpredictable and include endocrinopathies. The monoclonal antibody alemtuzumab is licensed for the treatment of MS but induces Graves’ disease in 22% of patients receiving the drug for this indication. Alemtuzumab targets CD52 which depletes mature lymphocytes. In this case report, a patient who developed Graves’ disease following alemtuzumab therapy is discussed and clinical considerations and pathophysiology are reviewed. CASE DESCRIPTION SK is a 37-year-old woman diagnosed with MS at 25, and also suffers from depression. SK began alemtuzumab treatment at aged 35, subsequently, she was found to have deranged TFTs (TSH