J Mult Scler Res. 2022; 2(1): 28-30 | DOI: 10.4274/jmsr.galenos.2022.2022-3-2

HPV-associated Anal and Genital Intraepithelial Neoplasia After Using Fingolimod in the Treatment of Relapsing-remitting Multiple Sclerosis: A Case Report

Melis Doganay Ocalan¹, Gulin Morkavuk¹, Asli Yarci Gursoy², Suleyman Ozdemir³, Alev Leventoglu^1
1Ufuk University Faculty of Medicine, Department of Neurology, Ankara, Turkey
²Ufuk University Faculty of Medicine, Department of Gynecology and Obstetrics, Ankara, Turkey
³Ufuk University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey

Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disease of the central nervous system, with inflammation and loss of myelin in axons. Fingolimod is the first oral disease-modifying agent approved for the treatment of relapsing-remitting MS. Here we aimed to present a patient with MS who developed human papillomavirus (HPV)-associated anal and genital intraepithelial neoplasia while on fingolimod treatment. A 19-year-old female patient presented with the complaint of diplopia. The diagnosis of MS was made based on imaging and cerebrospinal fluid results. She was treated first with beta-interferon 1a, then methotrexate, and finally fingolimod. While the patient was being followed without attack under fingolimod treatment, HPV-associated genital, and further, anal warts developed. This is a rare case that developed both cervical dysplasia and anal Condyloma acuminatum due to the HPV that developed after fingolimod treatment in a patient with MS. In conclusion, fingolimod treatment increases the risk of cervical HPV infection and related cancer in patients with MS.

Keywords: Multiple sclerosis, relapsing-remitting, fingolimod, HPV, cervical dysplasia

---

CITE