PRES Lille Nord de France, Université Catholique de Lille, Groupe Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine, Clinique de Neurologie, Lille, France.
Mult Scler. 2012 Jun;18(6):909-11. doi: 10.1177/1352458511428082. Epub 2011 Nov 2.
In this case report we describe the first non-fatal herpes simplex virus encephalitis (HSE) case with natalizumab for multiple sclerosis (MS). A 36-year-old woman, previously treated with immunomodulatory and immunosuppressive drugs for MS, developed acute encephalitis after 6 monthly natalizumab perfusions. Brain imaging demonstrated suggestive bi-temporal lesions. Herpes simplex virus type-1 DNA was detected in cerebrospinal fluid. The patient improved gradually after a 21-day course of intravenous acyclovir, but neuropsychiatric changes remained 5 months later. Our non-fatal case of HSE and other reported cases of herpes infections provide evidence of an increased risk with natalizumab and point to the need for clinicians to maintain awareness.
在本病例报告中，我们描述了首例使用那他珠单抗治疗多发性硬化症（MS）后发生非致命性单纯疱疹病毒脑炎（HSE）的病例。一名 36 岁女性，曾因 MS 接受免疫调节和免疫抑制药物治疗，在接受 6 个月那他珠单抗输注后出现急性脑炎。脑部影像学显示双侧颞叶病变。在脑脊液中检测到单纯疱疹病毒 1 型 DNA。患者在接受 21 天静脉用阿昔洛韦治疗后逐渐好转，但 5 个月后仍存在神经精神变化。我们的 HSE 非致命病例和其他报道的疱疹感染病例提供了那他珠单抗风险增加的证据，并表明临床医生需要保持警惕。
