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Progressive Multifocal Leukoencephalopathy after Natalizumab Monotherapy
Open accessAbstract
We describe progressive multifocal leukoencephalopathy (PML) caused by infection with human polyomavirus JC virus in a patient with multiple sclerosis who was treated with natalizumab. The first PML symptoms appeared after 14 monthly infusions of the drug. Magnetic resonance imaging (MRI) showed a presumed multiple sclerosis lesion, and JC virus DNA was not detected on polymerase-chain-reaction (PCR) assay of cerebrospinal fluid. The patient's symptoms worsened, and the diagnosis of PML was established with a more sensitive quantitative PCR assay after 16 infusions of natalizumab. Plasma exchange was used to accelerate clearance of natalizumab. Approximately 3 weeks after plasma exchange, an immune-reconstitution inflammatory syndrome appeared. JC virus DNA was no longer detectable on quantitative PCR assay, and the patient's symptoms improved.
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Cited by
Szczepiorkowski, Z. M., Winters, J. L., Bandarenko, N., Kim, H. C., Linenberger, M. L., Marques, M. B., Sarode, R., Schwartz, J., Weinstein, R., & Shaz, B. H. (2010) · Journal of Clinical Apheresis · doi:10.1002/jca.20240 · Cited by 508
Safety and immunotoxicity assessment of immunomodulatory monoclonal antibodies
Brennan, F. R., Morton, L. D., Spindeldreher, S., Kiessling, A., Allenspach, R., Hey, A., Müller, P., Frings, W., & Sims, J. (2010) · mAbs · doi:10.4161/mabs.2.3.11782 · Cited by 250
Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none
Barber, D. L., Andrade, B. B., Sereti, I., & Sher, A. (2012) · Nature Reviews Microbiology · doi:10.1038/nrmicro2712 · Cited by 169
Metadata
- Authors
- Lindå, H., von Heijne, A., Major, E. O., Ryschkewitsch, C., Berg, J., Olsson, T., & Martin, C.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2009-09-10
- Volume
- 361
- Issue
- 11
- Pages
- 1081-1087
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2130730608
- Cited by
- 218
- References
- 0
- FWCI
- 18.05
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Lindå, H., von Heijne, A., Major, E. O., Ryschkewitsch, C., Berg, J., Olsson, T., & Martin, C. (2009). Progressive Multifocal Leukoencephalopathy after Natalizumab Monotherapy. New England Journal of Medicine. https://doi.org/10.1056/nejmoa0810316
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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