Clinically silent PML and prolonged immune reconstitution inflammatory syndrome in a patient with multiple sclerosis treated with natalizumab

TY - JOUR

T1 - Clinically silent PML and prolonged immune reconstitution inflammatory syndrome in a patient with multiple sclerosis treated with natalizumab

AU - Blinkenberg, Morten

AU - Sellebjerg, Finn

AU - Leffers, Anne Mette

AU - Madsen, Camilla Gøbel

AU - Sørensen, Per Soelberg

PY - 2013/8

Y1 - 2013/8

N2 - We report the case of a woman with natalizumab-treated multiple sclerosis (MS) and clinically silent progressive multifocal leukoencephalopathy (PML) with an unusually long preclinical phase, followed by acute symptoms due to development of immune reconstitution inflammatory syndrome (IRIS). Furthermore, the course of the IRIS was prolonged and continued to progress even five months after natalizumab treatment was ceased. This case shows that PML and IRIS can have a considerably variable course in natalizumab-treated MS patients and underlines the need for PML screening in JC virus antibody-positive patients in order to detect clinically silent cases.

AB - We report the case of a woman with natalizumab-treated multiple sclerosis (MS) and clinically silent progressive multifocal leukoencephalopathy (PML) with an unusually long preclinical phase, followed by acute symptoms due to development of immune reconstitution inflammatory syndrome (IRIS). Furthermore, the course of the IRIS was prolonged and continued to progress even five months after natalizumab treatment was ceased. This case shows that PML and IRIS can have a considerably variable course in natalizumab-treated MS patients and underlines the need for PML screening in JC virus antibody-positive patients in order to detect clinically silent cases.

U2 - 10.1177/1352458513481010

DO - 10.1177/1352458513481010

M3 - Journal article

SN - 1352-4585

VL - 19

SP - 1226

EP - 1229

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

IS - 9

ER -