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Case Reports
Presumptive progressive multifocal leukoencephalopathy in multiple sclerosis after natalizumab therapy.
- Philipp Eisele, Kristina Szabo, Eva Hornberger, Martin Griebe, Michael G Hennerici, Bernd C Kieseier, and Achim Gass.
- Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Germany.
- J Neuroimaging. 2014 Jul 1;24(4):425-8.
Background And PurposeTo describe a patient with relapsing remitting MS who was treated with natalizumab for 36 months. First symptoms of presumptive progressive multifocal leukoencephalopathy (PML) appeared 14 weeks after her last natalizumab infusion.MethodsNeurological examination, MRI and CSF analysis were performed.ResultsThe lack of anti-inflammatory treatment response, clinical course, and serial MRI examinations showed lesion development typical for PML on diffusion-weighted and FLAIR MRI. CSF analysis for JC virus was tested negative twice.ConclusionsThis case represents a presumptive PML after discontinuation of natalizumab treatment-similar to the definition established for PML in HIV patients.Copyright © 2013 by the American Society of Neuroimaging.
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