PMID- 25368707
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20141104
LR  - 20200930
IS  - 1918-3003 (Print)
IS  - 1918-3011 (Electronic)
IS  - 1918-3003 (Linking)
VI  - 7
IP  - 1
DP  - 2015 Jan
TI  - Immune reconstitution inflammatory syndrome mimicking progressive multifocal 
      leucoencephalopathy in a multiple sclerosis patient treated with natalizumab: a 
      case report and review of the literature.
PG  - 65-8
LID - 10.14740/jocmr1888w [doi]
AB  - Natalizumab (NTM) represents an effective drug for the treatment of 
      relapsing-remitting multiple sclerosis (RRMS). Progressive multifocal 
      leucoencephalopathy (PML) is a potential life-threatening complication of NTM 
      treatment. A close follow-up and MRI monitoring of patients under NTM are 
      required to avoid such devastating complications. The case of a 47-year-old woman 
      with RRMS (EDSS 1.5) treated with NTM for 44 months is reported. The patient had 
      a relapse with mild cerebellar symptomatology and visual complaints. MRI revealed 
      a new area of abnormal signal intensity in the subcortical white matter of the 
      right parietal lobe with mild peripheral enhancement. Visual fields showed 
      scotomata mostly of the left eye. NTM was discontinued. JC virus (JCV) polymerase 
      chain reaction (PCR) in cerebrospinal fluid was negative. The patient received IV 
      corticosteroids for 5 days and then monthly for 2 months with subsequent clinical 
      and MRI improvement. On month 4, she presented with a new relapse with severe 
      ataxia, mild behavioral change, increase of cerebellar symptoms and internuclear 
      opthalmoplegia (EDSS 3.5). MRI showed reappearance of the right parietal lobe 
      lesion, with decreased size and less pronounced contrast enhancement. A new 2-cm 
      lesion was noted in the left cerebellar hemisphere with a speckled pattern of 
      contrast enhancement. JCV PCR was negative and the patient was treated with IV 
      corticosteroids. On month 12, she demonstrated clinical and MRI improvement. 
      Although initially PML was highly suspected in this patient, the clinical and MRI 
      findings were supportive of the presence of immune reconstitution inflammatory 
      syndrome (IRIS).
FAU - Evangelopoulos, Maria-Eleptheria
AU  - Evangelopoulos ME
AD  - Demyelinating Diseases Unit, Department of Neurology, University of Athens, 
      Eginition Hospital, Athens, Greece.
FAU - Koutoulidis, Vasilios
AU  - Koutoulidis V
AD  - Department of Radiology, University of Athens, Areteion Hospital, Athens, Greece.
FAU - Kilidireas, Kostas
AU  - Kilidireas K
AD  - Demyelinating Diseases Unit, Department of Neurology, University of Athens, 
      Eginition Hospital, Athens, Greece.
FAU - Evangelopoulos, Dimitrios-Stergios
AU  - Evangelopoulos DS
AD  - The 3rd Department of Orthopaedic Surgery, University of Athens, KAT Hospital, 
      Athens, Greece.
FAU - Nakas, Georgios
AU  - Nakas G
AD  - Demyelinating Diseases Unit, Department of Neurology, University of Athens, 
      Eginition Hospital, Athens, Greece.
FAU - Andreadou, Elisabeth
AU  - Andreadou E
AD  - Demyelinating Diseases Unit, Department of Neurology, University of Athens, 
      Eginition Hospital, Athens, Greece.
FAU - Moulopoulos, Lia-Angela
AU  - Moulopoulos LA
AD  - Department of Radiology, University of Athens, Areteion Hospital, Athens, Greece.
LA  - eng
PT  - Case Reports
DEP - 20141016
PL  - Canada
TA  - J Clin Med Res
JT  - Journal of clinical medicine research
JID - 101538301
PMC - PMC4217759
OTO - NOTNLM
OT  - Immune Reconstitution Inflammatory Syndrome
OT  - Leucoencephalopathy
OT  - Natalizumab
OT  - Sclerosis
EDAT- 2014/11/05 06:00
MHDA- 2014/11/05 06:01
PMCR- 2014/10/16
CRDT- 2014/11/05 06:00
PHST- 2014/07/01 00:00 [accepted]
PHST- 2014/11/05 06:00 [entrez]
PHST- 2014/11/05 06:00 [pubmed]
PHST- 2014/11/05 06:01 [medline]
PHST- 2014/10/16 00:00 [pmc-release]
AID - 10.14740/jocmr1888w [doi]
PST - ppublish
SO  - J Clin Med Res. 2015 Jan;7(1):65-8. doi: 10.14740/jocmr1888w. Epub 2014 Oct 16.