Abstract | BACKGROUND: METHODS: In the current paper, we describe 4 cases of NTZ-PML in EID included in the Italian PML cohort. RESULTS: The patients developed PML after at least 38 NTZ infusions. Their John Cunningham virus (JCv) index was > 1.5, and patients had not previously used immunosuppressant. Two patients were asymptomatic at PML onset, while two had mild motor impairment of the right hand and anomia, respectively. All of them had undetectable viral load but one (37 JCv copies/ml). In all patients, MRI revealed unilobar lesions with deferred contrast enhancement suggestive of immune reconstitution. The clinical course ended with a favorable clinical outcome (ΔEDSS up to 1). CONCLUSIONS: Although PML in EID seems to occur less frequently than in conventional dosing regimen, strict monitoring of high-risk patients contributed to the indolent course observed in the four described cases, characterized by a prolonged pre-symptomatic phase, paucisymptomatic onset, low JCv load, less severe functional impairment during immune reconstitution, and a mild disability burden.
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Authors | Cristina Scarpazza, Nicola De Rossi, Giulietta Tabiadon, Maria Vittoria Turrini, Simonetta Gerevini, Ruggero Capra |
Journal | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
(Neurol Sci)
Vol. 40
Issue 10
Pg. 2119-2124
(Oct 2019)
ISSN: 1590-3478 [Electronic] Italy |
PMID | 31175467
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Immunologic Factors
- Natalizumab
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Topics |
- Adult
- Female
- Humans
- Immunologic Factors
(administration & dosage, adverse effects)
- Leukoencephalopathy, Progressive Multifocal
(chemically induced)
- Male
- Middle Aged
- Natalizumab
(administration & dosage, adverse effects)
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