Abstract
Background: Alemtuzumab is a humanized anti -CD 52 monoclonal antibody approved as a disease -modifying therapy for active relapsing -remitting Multiple Sclerosis (MS). Alemtuzumab has been associated with several adverse effects, including infusion -associated reactions, infections, acquired autoimmune diseases, and malig- nancies. Case presentation: We report a case of Alemtuzumab-induced simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy and stroke in a 52 -year -old man that occurred 8 months after initiation of alemtuzumab. The laboratory testing was consistent with autoimmune haemolytic anaemia. Computed tomography of the chest and bronchoscopy revealed an alveolar haemorrhage. Stroke workup re- vealed acute infarcts in bilateral occipital territories. Conclusion: This is the first case report of a simultaneous onset of autoimmune haemolytic anaemia, alveolar haemorrhage, nephropathy, and ischaemic stroke after the first alemtuzumab course in relapsing -remitting MS patient. This case highlights the potential for the co -occurrence of unexpected and potentially life -threatening complications of alemtuzumab therapy necessitating rigorous monitoring once prescribed.