An adverse effect of Ocrelizumab treatment in a patient with multiple sclerosis: a case report of necrotizing periodontitis

Abstract

Multiple Sclerosis (MS) and Necrotizing Periodontitis (NP) are two diseases whose aetiologies and pathophysiologies do not appear to have a common link; however, treating MS with monoclonal antibodies and the decrease in humoral immunity that this entails can be a trigger or an aggravation in patients who present with quiescent NP. We describe a clinical case of NP, including clinical manifestations, treatment, and evolution during therapy with ocrelizumab and to review risk factors. A rapid progression of NP was evidenced. During the patient’s evolution, she suffered bilateral pneumonia due to coronavirus disease 2019, requiring treatment with corticosteroids and antibiotics, which led to clinical relief of her NP. Based on this case, we believe that regulated dental monitoring of patients with MS before, during, and after the administration of monoclonal antibodies may help prevent periodontal deterioration.