PMID- 27994897
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201229
IS  - 2090-6668 (Print)
IS  - 2090-6676 (Electronic)
IS  - 2090-6676 (Linking)
VI  - 2016
DP  - 2016
TI  - Progressive Multifocal Leukoencephalopathy in a Multiple Sclerosis Patient 
      Diagnosed after Switching from Natalizumab to Fingolimod.
PG  - 5876798
LID - 5876798
AB  - Background. Natalizumab- (NTZ-) associated progressive multifocal 
      leukoencephalopathy (PML) is a severe and often disabling infectious central 
      nervous system disease that can become evident in multiple sclerosis (MS) 
      patients after NTZ discontinuation. Recently, novel diagnostic biomarkers for the 
      assessment of PML risk in NTZ treated MS patients such as the anti-JC virus 
      antibody index have been reported, and the clinical relevance of milky-way 
      lesions detectable by MRI has been discussed. Case Presentation and Conclusion. 
      We report a MS patient in whom PML was highly suspected solely based on MRI 
      findings after switching from NTZ to fingolimod despite repeatedly negative 
      (ultrasensitive) polymerase chain reaction (PCR) testing for JC virus DNA in 
      cerebrospinal fluid. The PML diagnosis was histopathologically confirmed by brain 
      biopsy. The occurrence of an immune reconstitution inflammatory syndrome (IRIS) 
      during fingolimod therapy, elevated measures of JCV antibody indices, and the 
      relevance of milky-way-like lesions detectable by (7 T) MRI are discussed.
FAU - Sinnecker, Tim
AU  - Sinnecker T
AD  - Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany; 
      NeuroCure Clinical Research Center, Charite-Universitatsmedizin Berlin, Berlin, 
      Germany; Department of Neurology, Universitatsspital Basel, Basel, Switzerland.
FAU - Othman, Jalal
AU  - Othman J
AD  - Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany.
FAU - Kuhl, Marc
AU  - Kuhl M
AD  - Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany.
FAU - Metz, Imke
AU  - Metz I
AD  - Department of Neuropathology, Universitatsmedizin Gottingen, Gottingen, Germany.
FAU - Niendorf, Thoralf
AU  - Niendorf T
AD  - Berlin Ultrahigh Field Facility, Max Delbruck Center for Molecular Medicine, 
      Berlin, Germany; Experimental and Clinical Research Center, 
      Charite-Universitatsmedizin Berlin and Max Delbruck Center for Molecular 
      Medicine, Berlin, Germany.
FAU - Kunkel, Annett
AU  - Kunkel A
AD  - Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany.
FAU - Paul, Friedemann
AU  - Paul F
AUID- ORCID: 0000-0002-6378-0070
AD  - NeuroCure Clinical Research Center, Charite-Universitatsmedizin Berlin, Berlin, 
      Germany; Experimental and Clinical Research Center, Charite-Universitatsmedizin 
      Berlin and Max Delbruck Center for Molecular Medicine, Berlin, Germany; Clinical 
      and Experimental Multiple Sclerosis Research Center, Charite-Universitatsmedizin 
      Berlin, Berlin, Germany; Department of Neurology, Charite-Universitatsmedizin 
      Berlin, Berlin, Germany.
FAU - Wuerfel, Jens
AU  - Wuerfel J
AD  - NeuroCure Clinical Research Center, Charite-Universitatsmedizin Berlin, Berlin, 
      Germany; Medical Imaging Analysis Center AG, Basel, Switzerland.
FAU - Faiss, Juergen
AU  - Faiss J
AD  - Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany.
LA  - eng
PT  - Journal Article
DEP - 20161122
PL  - United States
TA  - Case Rep Neurol Med
JT  - Case reports in neurological medicine
JID - 101576451
PMC - PMC5138460
COIS- The authors declare that they have no competing interests.
EDAT- 2016/12/21 06:00
MHDA- 2016/12/21 06:01
PMCR- 2016/11/22
CRDT- 2016/12/21 06:00
PHST- 2016/06/01 00:00 [received]
PHST- 2016/08/21 00:00 [revised]
PHST- 2016/10/12 00:00 [accepted]
PHST- 2016/12/21 06:00 [entrez]
PHST- 2016/12/21 06:00 [pubmed]
PHST- 2016/12/21 06:01 [medline]
PHST- 2016/11/22 00:00 [pmc-release]
AID - 10.1155/2016/5876798 [doi]
PST - ppublish
SO  - Case Rep Neurol Med. 2016;2016:5876798. doi: 10.1155/2016/5876798. Epub 2016 Nov 
      22.