PMID- 27134676
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160502
LR  - 20210109
IS  - 1756-2856 (Print)
IS  - 1756-2864 (Electronic)
IS  - 1756-2856 (Linking)
VI  - 9
IP  - 3
DP  - 2016 May
TI  - Use of interleukin-2 for management of natalizumab-associated progressive 
      multifocal leukoencephalopathy: case report and review of literature.
PG  - 211-5
LID - 10.1177/1756285615621029 [doi]
AB  - A 51-year-old woman with relapsing-remitting multiple sclerosis (RRMS) and 3-year 
      history of natalizumab use developed expressive aphasia. A brain magnetic 
      resonance image (MRI) showed left frontotemporal and right parietal lesion with 
      mild contrast enhancement and cerebrospinal fluid (CSF) was positive for John 
      Cunningham virus (JCV) by polymerase chain reaction (PCR). The patient received 
      five cycles of plasmapheresis followed by intravenous immunoglobulin. Despite 
      this intervention, her speech deteriorated and she developed right hemiparesis. 
      Upon referral to our institution, CSF quantitative JCV PCR was notable for 834 
      copies/ml. The patient was given an initial dose of 50,000 units of interleukin-2 
      (IL-2) subcutaneously (SQ) followed by 1 million units IL-2 SQ daily. Due to 
      concern for immune reconstitution inflammatory syndrome (IRIS), the patient also 
      received intravenous methylprednisone weekly. The regimen was tolerated well by 
      the patient with no severe adverse effects. Clinically, the patient showed some 
      improvement, and became more responsive and regained right lower extremity 
      antigravity strength. After 12 weeks of IL-2 therapy, JCV quantitative PCR was 
      notable for 31 copies/ml and the patient was more responsive. Due to persistence 
      of JCV, IL-2 therapy was changed to mefloquine. At follow up after 6 months, the 
      patient showed no clinical deterioration.
FAU - Dubey, Divyanshu
AU  - Dubey D
AD  - Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, 
      5323 Harry Hines Blvd. Dallas, Texas-75235, USA.
FAU - Zhang, Yinan
AU  - Zhang Y
AD  - Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, 
      Dallas, Texas, USA.
FAU - Graves, Donna
AU  - Graves D
AD  - Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, 
      Dallas, Texas, USA.
FAU - DeSena, Allen D
AU  - DeSena AD
AD  - Department of Neurology, University of Cincinnati College of Medicine, 
      Cincinnati, Ohio, USA.
FAU - Frohman, Elliot
AU  - Frohman E
AD  - Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, 
      Dallas, Texas, USA.
FAU - Greenberg, Benjamin
AU  - Greenberg B
AD  - Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, 
      Dallas, Texas, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20151217
PL  - England
TA  - Ther Adv Neurol Disord
JT  - Therapeutic advances in neurological disorders
JID - 101480242
PMC - PMC4811009
OTO - NOTNLM
OT  - Immune Reconstitution Inflammatory Syndrome
OT  - Interleukin-2
OT  - Multiple sclerosis
OT  - Natalizumab
OT  - Progressive multifocal leukoencephalopathy
COIS- Conflict of interest statement: The author(s) declared the following potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article: D.G. has consulted for Teva Pharmaceuticals and 
      Bayer, has grants or grants pending from Novartis, and has received payment for 
      or given lectures for Teva Pharmaceuticals, Bayer, Novartis and Pfizer. A.D.D.'s 
      fellowship funding was provided by the Transverse Myelitis Association. E.F. has 
      received personal compensation as a speaker and consultant from Acorda 
      Therapeutics, Genzyme, Novartis International AG and Teva Pharmaceutical 
      Industries Ltd. B.G. owns stock or stock options and serves as a consultant for 
      Amplimmune, Inc. and DioGenix, Inc; he has also received personal compensation 
      for developing education presentations from MediLogix and for serving as a 
      consultant for Novartis International AG. D.D. and Y.Z. declare no conflicts of 
      interest in preparing this article.
EDAT- 2016/05/03 06:00
MHDA- 2016/05/03 06:01
PMCR- 2016/05/01
CRDT- 2016/05/03 06:00
PHST- 2016/05/03 06:00 [entrez]
PHST- 2016/05/03 06:00 [pubmed]
PHST- 2016/05/03 06:01 [medline]
PHST- 2016/05/01 00:00 [pmc-release]
AID - 10.1177_1756285615621029 [pii]
AID - 10.1177/1756285615621029 [doi]
PST - ppublish
SO  - Ther Adv Neurol Disord. 2016 May;9(3):211-5. doi: 10.1177/1756285615621029. Epub 
      2015 Dec 17.