PMID- 27904430
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201229
IS  - 1394-195X (Print)
IS  - 2180-4303 (Electronic)
IS  - 1394-195X (Linking)
VI  - 23
IP  - 5
DP  - 2016 Sep
TI  - Natalizumab-Related Progressive Multifocal Leukoencephalopathy-Immune 
      Reconstitution Inflammatory Syndrome: A Case Report Highlighting Clinical and MRI 
      Features.
PG  - 91-95
AB  - Multiple sclerosis (MS) patients treated with natalizumab often face the uncommon 
      but severe complication of developing progressive multifocal leukoencephalopathy 
      (PML). PML may be further complicated by immune reconstitution inflammatory 
      syndrome (IRIS) after the removal of the drug. Since both PML and IRIS are 
      associated with high morbidity and mortality rates, early clinical and 
      radiological diagnosis of these complications is of paramount importance. Here, 
      we report a case of an adult male patient who was diagnosed with PML after 
      receiving natalizumab therapy for 6 years for the treatment of MS. Upon cessation 
      of natalizumab, he presented with a paradoxical worsening of clinical and 
      radiological findings consistent with an inflammatory brain injury due to IRIS. 
      He was treated with high dose corticosteroid therapy followed by a gradual 
      improvement in clinical and imaging findings. This article illustrates the 
      magnetic resonance imaging (MRI) features of natalizumab-associated PML-IRIS, 
      along with a brief overview of its clinical features, complications and 
      management strategies.
FAU - Purohit, Bela
AU  - Purohit B
AD  - Institute for Neuroradiology, University Hospital of Zurich, Frauenklinikstrasse 
      10, 8091 Zurich, Switzerland; Dept. of Neuroradiology, National Neuroscience 
      Institute, 11 Jalan Tan Tock Seng, Singapore-308433.
FAU - Ganewatte, Eranga
AU  - Ganewatte E
AD  - Institute for Neuroradiology, University Hospital of Zurich, Frauenklinikstrasse 
      10, 8091 Zurich, Switzerland.
FAU - Kollias, Spyros S
AU  - Kollias SS
AD  - Institute for Neuroradiology, University Hospital of Zurich, Frauenklinikstrasse 
      10, 8091 Zurich, Switzerland.
LA  - eng
PT  - Case Reports
DEP - 20161005
PL  - Malaysia
TA  - Malays J Med Sci
JT  - The Malaysian journal of medical sciences : MJMS
JID - 101126308
PMC - PMC5101973
OTO - NOTNLM
OT  - immune reconstitution inflammatory syndrome
OT  - magnetic resonance imaging
OT  - multiple sclerosis
OT  - natalizumab
OT  - progressive multifocal leukoencephalopathy
COIS- No conflict of interests.
EDAT- 2016/12/03 06:00
MHDA- 2016/12/03 06:01
PMCR- 2016/09/01
CRDT- 2016/12/02 06:00
PHST- 2015/08/20 00:00 [received]
PHST- 2015/12/05 00:00 [accepted]
PHST- 2016/12/02 06:00 [entrez]
PHST- 2016/12/03 06:00 [pubmed]
PHST- 2016/12/03 06:01 [medline]
PHST- 2016/09/01 00:00 [pmc-release]
AID - 12mjms23052016_cr1 [pii]
AID - 10.21315/mjms2016.23.5.12 [doi]
PST - ppublish
SO  - Malays J Med Sci. 2016 Sep;23(5):91-95. doi: 10.21315/mjms2016.23.5.12. Epub 2016 
      Oct 5.