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Q&A 57: Is my pseudorelapse due to smouldering MS?
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Q&A 57: Is my pseudorelapse due to smouldering MS?

I am hoping that in the future, we will be able to distinguish between true relapses (new focal inflammatory activity) and pseudorelapses by measuring blood neurofilament levels.

Case 1 - Can zoledronic acid cause a T-cell pro-inflammatory response, i.e. a cytokine release syndrome? Since having my first infusion, my MS has become active again. 

Case 2 - I am a 35-year-old woman with RRMS on ocrelizumab (Ocrevus). I am considering starting a weight loss injection, Mounjaro, to help me lose weight alongside exercise and healthy eating. I wanted to ask if there were any known risks involved in these injections for MS patients.

NOTE: General substack newsletters and microsite are free; only Q&A sessions are restricted to paying subscribers. I can't run and maintain the MS-Selfie microsite, hence the need to pay people to help me do the work. If people want to ask medical questions unrelated to the Newsletters or Podcasts, they either need to become paying subscribers or email (ms-selfie@giovannoni.net) to request a complimentary subscription.

Prof G’s answer

In an ideal world, this patient would have her blood neurofilament level measured to help diagnose her symptoms……

How smouldering MS sets the stage for a pseudorelapse despite the symptoms being new.

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