PMID- 26265277
OWN - NLM
STAT- MEDLINE
DCOM- 20160222
LR  - 20150812
IS  - 2211-0356 (Electronic)
IS  - 2211-0348 (Linking)
VI  - 3
IP  - 5
DP  - 2014 Sep
TI  - Immune reconstitution inflammatory syndrome and natalizumab-Is it possible before 
      removing the drug?
PG  - 659-61
LID - S2211-0348(14)00067-4 [pii]
LID - 10.1016/j.msard.2014.07.001 [doi]
AB  - Multiple sclerosis (MS) patients treated with natalizumab have a significant 
      reduction in annualized relapse rate; in these patients, a relapse is uncommon 
      but not unexpected. In contrast, the appearance of a severe exacerbation is 
      striking and requires the differential diagnosis with progressive multifocal 
      leukoencephalopathy. Here, we describe a case of a 22-year-old woman with 
      relapsing-remitting MS who developed an unexpected response after the patient׳s 
      fifth natalizumab infusion with an aggressive radiological and clinical 
      evolution. Changing the patient׳s treatment to fingolimod resulted in the absence 
      of new clinical relapses and the absence of active lesions on brain magnetic 
      resonance images (MRI) during the first 12 months of follow-up. We hypothesize 
      that the appearance of natalizumab antibodies in this patient triggered 
      lymphocyte migration to the central nervous system in a rebound phenomenon; this 
      is similar to what occurs during immune reconstitution inflammatory syndrome 
      (IRIS) after removal of natalizumab.
CI  - Copyright (c) 2014 Elsevier B.V. All rights reserved.
FAU - Mulero, P
AU  - Mulero P
AD  - Neurology Department, Hospital Clinico Universitario de Valladolid, Avenida Ramon 
      y Cajal, 3, ZP: 47005, Castilla y Leon, Valladolid, Spain. Electronic address: 
      pamuca84@hotmail.com.
FAU - Neri, M J
AU  - Neri MJ
AD  - Neurology Department, Hospital Clinico Universitario de Valladolid, Avenida Ramon 
      y Cajal, 3, ZP: 47005, Castilla y Leon, Valladolid, Spain.
FAU - Rodriguez, M
AU  - Rodriguez M
AD  - Radiology Department, Hospital Clinico Universitario de Valladolid, Castilla y 
      Leon, Spain.
FAU - Arenillas, J F
AU  - Arenillas JF
AD  - Neurology Department, Hospital Clinico Universitario de Valladolid, Avenida Ramon 
      y Cajal, 3, ZP: 47005, Castilla y Leon, Valladolid, Spain.
FAU - Tellez, N
AU  - Tellez N
AD  - Neurology Department, Hospital Clinico Universitario de Valladolid, Avenida Ramon 
      y Cajal, 3, ZP: 47005, Castilla y Leon, Valladolid, Spain.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20140721
PL  - Netherlands
TA  - Mult Scler Relat Disord
JT  - Multiple sclerosis and related disorders
JID - 101580247
RN  - 0 (Immunologic Factors)
RN  - 0 (Natalizumab)
SB  - IM
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*chemically 
      induced/*diagnosis/prevention & control
MH  - Immunologic Factors/administration & dosage/adverse effects
MH  - Multiple Sclerosis, Relapsing-Remitting/*complications/*drug therapy
MH  - Natalizumab/*administration & dosage/*adverse effects
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Immune reconstitution inflammatory syndrome (IRIS)
OT  - Natalizumab
OT  - Neutralizing antibodies
OT  - Rebound
OT  - Relapse
EDAT- 2015/08/13 06:00
MHDA- 2016/02/24 06:00
CRDT- 2015/08/13 06:00
PHST- 2014/03/20 00:00 [received]
PHST- 2014/06/25 00:00 [revised]
PHST- 2014/07/14 00:00 [accepted]
PHST- 2015/08/13 06:00 [entrez]
PHST- 2015/08/13 06:00 [pubmed]
PHST- 2016/02/24 06:00 [medline]
AID - S2211-0348(14)00067-4 [pii]
AID - 10.1016/j.msard.2014.07.001 [doi]
PST - ppublish
SO  - Mult Scler Relat Disord. 2014 Sep;3(5):659-61. doi: 10.1016/j.msard.2014.07.001. 
      Epub 2014 Jul 21.