Case Report/Case SeriesManagement of Fulminant Multiple Sclerosis With Rituximab A Case ReportParfenov, Valeriy MD; Du Pasquier, Renaud MD; Schluep, Myriam MDAuthor Information Department of Neurology, Division of Neuroimmunology, University Hospital of Lausanne, Lausanne, Switzerland V.P. has received travel stipend for scientific meetings from Novartis. R.D.P. has received travel grants and/or honoraria for talks from Bayer, Biogen idec, Merck. Serono, Novartis, and Teva. M.S. has received travel grants and/or honoraria for talks from Bayer, Biogen idec, Merck. Serono, Novartis, and Teva. Reprints: Valeriy Parfenov, MD, Department of Neurology, Division of Neuroimmunology, University Hospital of Lausanne, Rue du Bugnon 46, BH07-454, Lausanne 1011, Switzerland. E-mail: [email protected]. The Neurologist: June 2015 - Volume 19 - Issue 6 - p 155-157 doi: 10.1097/NRL.0000000000000030 Buy Metrics Abstract Introduction: Malignant variant is a rare subtype of multiple sclerosis (MS) that is rapidly progressive and may lead to significant disability or even death. No consensus exists on best management of this disorder, although corticosteroids and plasmapheresis are commonly used in the acute phase, followed either by MS-specific disease-modifying therapy or an immunosuppressant. Case Report: The patient is a 30-year-old man with relapsing-remitting MS previously well controlled with natalizumab, who has developed fulminant disease activity upon natalizumab cessation. In the acute phase, patient had a suboptimal response to multiple corticosteroid treatments but responded very well to plasmapheresis. Patient continued to have worsening disease activity despite fingolimod treatment. Disease control has been eventually achieved by switching to rituximab. Conclusion: Rituximab treatment should be considered for a patient with fulminant MS who responded well to plasmapheresis. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.