Rare but serious liver and pancreas reaction after MS shot

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Key Takeaway

A recently approved MS medicine (ofatumumab) may very rarely trigger severe autoimmune liver inflammation and dangerous pancreatitis, so prompt medical attention and careful monitoring are important when starting this drug.

What They Found

A man in his 30s with newly diagnosed MS got better with steroids but then began ofatumumab treatment. Days after his first injection he developed yellow skin (jaundice), belly pain, and vomiting, which turned out to be severe liver inflammation caused by his immune system attacking his liver (autoimmune hepatitis). Tests also showed problems with blood clotting and high pancreas enzymes, and scans later showed a blocked gallbladder and a life-threatening form of pancreas damage (necrotising pancreatitis). Doctors stopped ofatumumab, treated him with steroids and supportive care, and his liver and stomach problems gradually improved. His MS stayed stable and he had no lasting nerve problems after treatment and follow-up imaging.

Who Should Care and Why

People with MS and their caregivers should know that although this reaction is rare, it can appear very quickly after the first dose — like an unexpected allergic reaction but affecting the liver and pancreas. Patients starting ofatumumab (or other B-cell–targeting drugs) should watch for signs such as yellowing of the skin or eyes, severe belly pain, dark urine, pale stools, fever, nausea, or unusual bleeding and seek care quickly. Healthcare providers prescribing the drug should consider baseline liver and pancreatic checks and educate patients about early warning signs so problems can be caught early, similar to checking tire pressure before a long drive. Caregivers can help by noticing subtle changes in appetite, energy, or color of skin/eyes and getting medical help right away. Those with a history of gallstones, liver disease, or unusual immune problems should discuss risks with their neurologist because extra caution or alternatives might be better.

Important Considerations

This report describes a single patient, so we can’t know how often this problem happens — rare side effects sometimes appear as single cases. We can’t prove the drug definitely caused the illness, only that the timing and tests make it likely; other things like gallstones may have played a role. Because of those limits, patients shouldn’t panic but should be informed and watchful; decisions about continuing or starting the drug should be made with a neurologist and possibly a liver or stomach specialist.

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Treatment Updates Specific Symptoms Clinical Trials

Article Topics:

ImmunologyMultiple sclerosis

Whether you’ve recently been diagnosed with Multiple Sclerosis (MS) or are seeking to broaden your understanding of this complex, neurodegenerative disease, navigating the latest research can feel overwhelming. Studies published in respected medical journals like BMJ case reports often range from early-stage, exploratory work to advanced clinical trials. These evidence-based findings help shape new disease-modifying therapies, guide symptom management techniques, and deepen our knowledge of MS progression.

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By presenting a wide range of MS-focused studies—spanning cutting-edge treatments, emerging therapies, and established best practices—we aim to empower patients, caregivers, and clinicians to stay informed and make well-informed decisions when managing Multiple Sclerosis.

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