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I was diagnosed with MS 7 years ago. I have been on Tysabri for 3 years and haven’t had any major side affects. I’ve just had blood tests done and my white blood cells are high. The doctor thinks it could be from the Tysabri but also indicated if not from Tysabri it could be leukemia. Should I contact my consultants at the Austin Hospital in Melbourne where I see my neurologist to discuss with them? I'm trying not to get overwhelmed. Answer: It is not uncommon to see elevated white blood counts in patients on Tysabri. The majority of the time, the total white blood count (WBC) will remain less than 15,000, but on occasion we see elevations as high as 20,000. This is a result of the normal mechanism of action of Tysabri and not harmful at all. The type of white blood cells seen on the blood smear include normal white blood cells and some precursor cells. The elevations in total WBC begin as early as a month after the first dose and tend to persist. Some cell types, for instance monocytes, may show continued elevations over the first year. If your WBC elevation has been present since the start of treatment, there is no cause of concern. If your WBC elevation is new or much higher than previously, then you should probably be evaluated by a hematologist. They specialize in disorders of blood cells. Leukemia will cause an elevation of both normal and abnormal blood cell types and is typically very easy to differentiate from the WBC elevations observed in people on Tysabri. If your doctor(s) has a question, I suggest they contact a local MS specialist or call the Biogen Medical Liaison Office. Let us know what you learn. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Question:
I was diagnosed with MS 4 years ago and had gotten tattoos before the diagnosis. Is it safe to get a tattoo now? I lost my beloved pet of 16 years and would like to get a memorial of his name on my calf. Answer: We have had many questions about tattoos. Please see this link to see all the questions and answers regarding tattoos. READ MORE Here is My Question:
Can you get a tattoo when you have MS? Answer: We know of no problems with modern tattoos in people with MS. Older tattoos (before 1980) sometimes used metallic dyes that could interfere with MRI scans, but this is not the case anymore. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Need help. I have RRMS. I’m currently on Ocrevus, just started in May. I have a question about the MS hug. For me this is my number one horrible symptom. It is debilitating when it happens. It has happened almost daily for quite sometime and it causes me so much pain and difficulty breathing. I am on Magnesium Oxalate 500mg at night with no obvious improvement. All of my labs are normal. I tried Baclofen, flexeril, Xanax and no help. It is unpredictable but mostly mid day when I’m trying to work. I was just prescribed Topiramate ER 25mg to see if it helps. Have you ever heard of improvement with topiramate with this symptom? Have you ever suggested Botox of the intercostals for it and any positive outcome? I’m just out of options and the pain is terrible. Answer: The "MS hug”, an inappropriately affectionate moniker for this annoying symptom, is an illusion of painful constriction sometimes associated with burning or jabbing sensations in a band around the trunk. Sometimes this feels like a tight belt wrapped around you. When it occurs at chest level it gives the illusion that you are short of breath or not able to take a deep enough breath. This band of constriction usually occurs at the dermatome level associated with a spinal cord MS lesion, although we occasionally can not visualize an abnormality at this level on MRI scanning. Treatment for this symptoms is at times difficult. The usual sequence of symptomatic treatments includes the following list in this order:
If the MS Hug occurs acutely (not a chronic symptom), it sometimes responds to high dose iv steroid treatment. We rarely find any benefit from the medications mentioned in your question. Some doctors report success with topiramate but I have been disappointed with its benefits for this indication. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Is it true that the older we become the fewer relapses we have? Answer: It is true that the frequency of relapses is inversely related to age; in other words, the older you become the fewer the relapses even without treatment. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Can Copaxone cause cancer? Answer: There is no evidence that Copaxone can cause cancer Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
When are periventricular and juxtacortical lesions on the same brain mri non-specific and NOT consistent with MS? Is it possible these could be normal in a healthy person in 40s? Also, do the healthcarejourney.com doctors still read mris if individuals would like a second read? Thanks in advance for your answers. Answer: No MRI pattern is 100% specific for MS; this is why we can not and do not diagnose even young people with MS when an MRI obtained for another reason shows findings that look like classic MS. The actual risk of these individuals developing MS is only 30%. Revere (Rip) Kinkel MD Professor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego |
PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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