那他珠单抗治疗后多发性硬化症中疑似进行性多灶性白质脑病
Presumptive progressive multifocal leukoencephalopathy in multiple sclerosis after natalizumab therapy.
作者信息
Eisele Philipp, Szabo Kristina, Hornberger Eva, Griebe Martin, Hennerici Michael G, Kieseier Bernd C, Gass Achim
机构信息
Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Germany.
出版信息
J Neuroimaging. 2014 Jul-Aug;24(4):425-8. doi: 10.1111/jon.12010. Epub 2013 Jan 16.
BACKGROUND AND PURPOSE
To 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.
METHODS
Neurological examination, MRI and CSF analysis were performed.
RESULTS
The 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.
CONCLUSIONS
This case represents a presumptive PML after discontinuation of natalizumab treatment-similar to the definition established for PML in HIV patients.
背景与目的
描述一名复发缓解型多发性硬化症患者，其接受那他珠单抗治疗36个月。在她最后一次输注那他珠单抗14周后，出现了疑似进行性多灶性白质脑病（PML）的首发症状。
方法
进行了神经学检查、磁共振成像（MRI）和脑脊液分析。
结果
缺乏抗炎治疗反应、临床病程以及系列MRI检查显示，在扩散加权和液体衰减反转恢复序列（FLAIR）MRI上出现了PML典型的病灶发展情况。脑脊液中JC病毒检测两次均为阴性。
结论
该病例代表了那他珠单抗治疗停药后疑似PML——类似于为HIV患者中PML所确立的定义。
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