[Guidelines for the Management of Secondary Hypogammaglobulinemia in Multiple Sclerosis Patients on Anti-CD20 Monoclonal Antibody Therapy].

Hypogammaglobulinemia is a common laboratory complication in patients with multiple sclerosis treated with anti-CD20 monoclonal antibodies, and it may be associated with an increased risk of infections. This guideline, developed by the Cerebrospinal Fluid Study and Research Unit of Unidade Local de Saúde São João, proposes a structured approach for the assessment and management of this condition. It outlines strategies for infection risk mitigation both before and during therapy, as well as the indications for initiating immunoglobulin replacement therapy when appropriate. The aim is to support clinical decision-making by promoting a safe, individualized, and patient-centered intervention.