Guidelines for the Management of Secondary Hypogammaglobulinemia in Multiple Sclerosis Patients on Anti-CD20 Monoclonal Antibody Therapy

Authors

  • André Aires Fernandes Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto.
  • Ana Lídia Neves Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto.
  • Daniela Ferro Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto.
  • Mafalda Seabra Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto.
  • Ricardo Soares dos Reis Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto. https://orcid.org/0000-0001-6878-8568
  • Teresa Mendonça Serviço de Neurologia. Unidade Local de Saúde de São João. Porto.
  • Cândida Abreu Serviço de Doenças Infeciosas. Hospital de São João. Unidade Local de Saúde de São João. Porto. & Departamento de Medicina. Faculdade de Medicina. RISE-Health. Universidade do Porto. Porto. https://orcid.org/0000-0001-6464-7063
  • Joana Guimarães Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto.
  • Pedro Abreu Serviço de Neurologia. Unidade Local de Saúde de São João. Porto. & Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto. https://orcid.org/0000-0002-7927-0294

DOI:

https://doi.org/10.20344/amp.24365

Keywords:

Agammaglobulinemia/chemically induced, Antibodies, Monoclonal, Humanized/adverse effects, Immunologic Factors/adverse effects, Infections/ prevention and control, Multiple Sclerosis/drug therapy

Abstract

Hypogammaglobulinemia is a common laboratory complication in patients with multiple sclerosis treated with anti-CD20 monoclonal antibodies, and it may be associated with an increased risk of infections. This guideline, developed by the Cerebrospinal Fluid Study and Research Unit of Unidade Local de Saúde São João, proposes a structured approach for the assessment and management of this condition. It outlines strategies for infection risk mitigation both before and during therapy, as well as the indications for initiating immunoglobulin replacement therapy when appropriate. The aim is to support clinical decision-making by promoting a safe, individualized, and patient-centered intervention.

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References

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Published

2026-07-15

How to Cite

1.
Aires Fernandes A, Neves AL, Ferro D, Seabra M, Soares dos Reis R, Mendonça T, Abreu C, Guimarães J, Abreu P. Guidelines for the Management of Secondary Hypogammaglobulinemia in Multiple Sclerosis Patients on Anti-CD20 Monoclonal Antibody Therapy. Acta Med Port [Internet]. 2026 Jul. 15 [cited 2026 Jul. 20];. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/24365

Issue

Section

Guidelines