2026-10-13T05:51:37Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34030977 2026-09-30T09:40:35Z category_7 portal_147 item_type_3 month_year_09_2026

Supplemental Material for: Rebound-Like Inflammatory Activity Presenting as a Tumefactive Demyelinating Lesion after Teriflunomide Discontinuation: A Case Report figshare admin karger (2628495) Alpkağan Kale (25142922) Nermin Tepe (17445369) Medicine Medicine <p dir="ltr">Introduction: Rebound after teriflunomide discontinuation is uncommon and difficult to distinguish from ordinary disease reactivation without a documented pretreatment baseline. Tumefactive demyelination is a rarely reported post-cessation phenotype. Case Presentation: A 39-year-old woman with relapsing–remitting multiple sclerosis had no relapses, EDSS worsening, or new MRI lesions during approximately five years of teriflunomide treatment. She stopped treatment without medical supervision or an accelerated elimination procedure for pregnancy planning. Four months later, persistent headache prompted MRI, which showed a 2.6 × 2.6 cm right frontal periventricular tumefactive demyelinating lesion with edema, peripheral diffusion restriction, and mild ring enhancement, plus a new left cerebellar plaque. EDSS remained 0. Absolute lymphocyte count rose from 600 cells/μL at the last on-treatment visit to 1,700 cells/μL at presentation. Serum MOG-IgG and AQP4-IgG and CSF cytology were negative; a type 2 oligoclonal-band pattern was present, and targeted infectious screening showed no evidence of active infection. Teriflunomide was <0.02 mg/L twice, 14 days apart. Intravenous methylprednisolone (1 g/day for five days) resolved the headache. Cladribine was then started, and one-month MRI showed marked regression. EDSS remained 0 and no new or enhancing lesion appeared through 12 months. Conclusion: The tumour-like lesion exceeded the patient's pretreatment radiological phenotype, but the absence of objective deficit, EDSS worsening, and a high lesion burden makes definitive rebound uncertain. Rebound-like post-cessation inflammatory activity is the most defensible description. Supervised treatment transition and clinical and MRI monitoring are important when teriflunomide is stopped.</p> 2026-09-30T09:40:35Z Dataset Dataset 10.6084/m9.figshare.34030977.v1 https://figshare.com/articles/dataset/Supplemental_Material_for_Rebound-Like_Inflammatory_Activity_Presenting_as_a_Tumefactive_Demyelinating_Lesion_after_Teriflunomide_Discontinuation_A_Case_Report/34030977 CC BY 4.0