Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): "a case report from Ireland with review of literature, clinical pitfalls and future direction".
Authors
Mansoor, SalmanMullane, Gerard
Adenan, Mohammad Hijaz
Kelly, Siobhan
Water, Aine
McPartland, Grainne
Murphy, Kevin
Issue Date
2021-01-07Keywords
CidofovirMirtazapine
multiple sclerosis
Natalizumab
Progressive multifocal leukoencephalopathy
Steroids
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The Egyptian journal of neurology, psychiatry and neurosurgeryDOI
10.1186/s41983-020-00260-6PubMed ID
33437143Abstract
Background: Progressive multifocal leukoencephalopathy (PML) is one of the most serious treatment-related complications that is encountered in patients with multiple sclerosis (MS). PML is a serious complication of MS treatment which is most commonly related to natalizumab. Case presentation: We report clinical course of progressive multifocal leukoencephalopathy (PML) in a 40-year-old man who was on treatment for highly active relapsing-remitting multiple sclerosis with natalizumab (Nz). He was treated with steroids, cidofovir, and mirtazapine and went on to develop long-term disability. The case describes the evolution of PML from diagnosis up till 5 months with changes on sequential brain scans and clinical symptoms in our patient. Conclusion: Patients who are on natalizumab should be aware and consented for the risk of PML. They should be periodically re-assessed for their relative PML risk. There is a growing body of evidence that suggests switching patients from natalizumab who have a higher risk of PML to other safer treatment options.Item Type
OtherLanguage
enISSN
1110-1083ae974a485f413a2113503eed53cd6c53
10.1186/s41983-020-00260-6
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