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Background and Objective:The most common adverse events following Alemtuzumab include adverse infusion reactions, infections and autoimmune disorders. Skin adverse events are common during infusion but there are few reported cases of long-term skin autoimmune disease.Methods:A retrospective case series of patients developing long-term autoimmune skin disorders following alemtuzumab administration in a tertiary care hospital.Results:Of 133 patients treated with alemtuzumab, eight patients (6.02%) developed nine autoimmune cutaneous adverse events, including four events of alopecia areata, two of vitiligo, two of chronic urticaria and one of inflammatory atrichia. Three of them occurred between the first and the second infusion.Discussion:The lesions described are secondary to autoimmune disorders, probably related to immune dysregulation due to a differential lymphocyte repopulation following alemtuzumab. Autoimmune cutaneous adverse events may be frequent, and it would be recommended to monitor its appearance in order to treat them.

A 45-year-old woman developed an intermittent gait disorder and agoraphobia that was initially diagnosed as a functional movement disorder (FMD). Examination revealed fluctuating left leg stiffness with a hung-up reflex (Video 1). Neuroimaging and laboratory testing were normal (including thyroid function). EMG showed continuous motor unit activity in the left leg muscles. Elevated serum (>2,000 U/mL) and CSF (21.09 U/mL) GAD65 antibodies were found consistent with stiff limb syndrome, a rare variant of stiff-person syndrome (SPS). Symptoms responded to diazepam. The hung-up reflex has been classically described in hypothyroidism and Huntington disease,1 and this case suggests that it may also be a feature of SPS.2 This clinical finding should be kept in mind when assessing patients with FMD.