Alopecia Universalis in a Multiple Sclerosis Patient After Switching From Rituximab to Ocrelizumab: A Case Report

Abstract

Ocrelizumab is a humanized monoclonal antibody, which acts as an anti-CD20 antibody. It is used as a treatment of both relapsing–remitting multiple sclerosis (RRMS) and Progressive types. The aim of this study is to report the first patient with alopecia universalis after switching from rituximab to ocrelizumab. A 37-year-old woman with a history of SPMS, diagnosed 8 years ago, used to be treated with rituximab. Her drug was switched to ocrelizumab from 6 months ago. She presented with patchy scalp hair loss a day after receiving the second dose of ocrelizumab. Her hair loss rapidly progressed in 3–4 days to total body hair loss in a patchy pattern. Ocrelizumab may be responsible for autoimmune reactions such as alopecia universalis in immunocompromised patients.