芬戈莫德相关性进行性多灶性白质脑病中广泛免疫重建炎症综合征：附 7T MRI 数据的一例病例报告。
Extensive immune reconstitution inflammatory syndrome in Fingolimod-associated PML: a case report with 7 Tesla MRI data.
机构信息
Department of Neurology, Universitätsspital, Basel, Switzerland.
Medical Image Analysis Center Basel, Basel, Switzerland.
出版信息
BMC Neurol. 2019 Aug 9;19(1):190. doi: 10.1186/s12883-019-1407-2.
BACKGROUND
Progressive multifocal leukoencephalopathy (PML) is a rare complication of patients treated with fingolimod.
CASE PRESENTATION
Routine MRI eventually led to diagnosis of asymptomatic early PML that remained stable after discontinuation of fingolimod. As blood lymphocyte counts normalized, signs of immune reconstitution inflammatory syndrome (IRIS) and renewed MS activity developed. Both, advanced laboratory and ultrahigh field MRI findings elucidated differences between PML and MS.
CONCLUSIONS
In our case, early discontinuation of fingolimod yielded a good outcome, lymphocyte counts reflected immune system activity, and paraclinical findings helped to differentiate between PML-IRIS and MS.
背景
进行性多灶性白质脑病（PML）是接受芬戈莫德治疗的患者的一种罕见并发症。
病例介绍
常规 MRI 最终诊断为无症状早期 PML，停用芬戈莫德后病情稳定。随着血淋巴细胞计数恢复正常，出现了免疫重建炎症综合征（IRIS）和复发性 MS 活动的迹象。先进的实验室和超高场 MRI 检查结果阐明了 PML 和 MS 之间的差异。
结论
在我们的病例中，早期停用芬戈莫德产生了良好的结果，淋巴细胞计数反映了免疫系统的活动，而临床前发现有助于区分 PML-IRIS 和 MS。
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