TY - JOUR
T1 - Progressive multifocal leukoencephalopathy with extended natalizumab dosing
AU - Baldassari, Laura E.
AU - Jones, Stephen E.
AU - Clifford, David B.
AU - Fox, Robert J.
N1 - Funding Information:
L.E. Baldassari has served on a scientific advisory board for Teva and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1606-24540). S.E. Jones serves on a scientific advisory board for Biogen; has received speaker honoraria from Siemens and Monteris; receives publishing royalties from MRI Atlas of Pituitary Pathology (Elsevier, 2015); and receives research support from Biogen, NIH, US Department of Defense, and Congressionally Directed Medical Research Programs. D.B. Clifford has served/serves on scientific advisory boards for Amgen, Astra Zeneca, Biogen Idec/Quintiles, Bristol Myers Squibb, Genentech/Roche, Merck/Serono, Pfizer, Shire Pharmaceutical, Millennium/Takeda Pharmaceutical, Wave Pharma, Dr Reddy Pharma, Mitsubishi Tanabe Pharma, Gen-zyme (Sanofi), GlaxoSmithKline, Roche, Protagonist, Inhib-ikase, and Novartis; receives research support from NIH (NIMH, NIA, NIAID, NINDS, NCATS); and has participated in medico-legal cases. R.J. Fox serves on scientific advisory boards for Biogen Idec and Novartis; serves on editorial boards
Publisher Copyright:
© © 2018 American Academy of Neurology.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - A 53-year-old man with an 18-year history of multiple sclerosis (MS) was treated with natalizumab for 7 years. Two years prior to presentation, natalizumab treatment interval was increased to every 6 weeks in attempt to reduce the risk of PML. Medical history was notable for cutaneous T-cell lymphoma status-post CHOP chemotherapy. JCV serology was positive (index 2.8). He presented to our tertiary referral center for consultation due to 8 months of progressive left-sided paresthesias, 4 months of right arm clumsiness, and several weeks of expressive aphasia. Neurologic examination was consistent with these symptoms. Serial brain MRIs demonstrated progressive development of a subcortical, multifocal T2/fluid-attenuated inversion recovery hyperintensity in the left frontoparietal white matter (figure 1). Subtle but definite MRI abnormalities were present in the same area 12 months prior. His clinical course and MRI findings prompted urgent evaluation for PML.
AB - A 53-year-old man with an 18-year history of multiple sclerosis (MS) was treated with natalizumab for 7 years. Two years prior to presentation, natalizumab treatment interval was increased to every 6 weeks in attempt to reduce the risk of PML. Medical history was notable for cutaneous T-cell lymphoma status-post CHOP chemotherapy. JCV serology was positive (index 2.8). He presented to our tertiary referral center for consultation due to 8 months of progressive left-sided paresthesias, 4 months of right arm clumsiness, and several weeks of expressive aphasia. Neurologic examination was consistent with these symptoms. Serial brain MRIs demonstrated progressive development of a subcortical, multifocal T2/fluid-attenuated inversion recovery hyperintensity in the left frontoparietal white matter (figure 1). Subtle but definite MRI abnormalities were present in the same area 12 months prior. His clinical course and MRI findings prompted urgent evaluation for PML.
UR - http://www.scopus.com/inward/record.url?scp=85054005904&partnerID=8YFLogxK
U2 - 10.1212/CPJ.0000000000000457
DO - 10.1212/CPJ.0000000000000457
M3 - Article
C2 - 30105172
AN - SCOPUS:85054005904
SN - 2163-0402
VL - 8
SP - e12-e14
JO - Neurology: Clinical Practice
JF - Neurology: Clinical Practice
IS - 3
ER -