PMID- 31399069
OWN - NLM
STAT- MEDLINE
DCOM- 20191129
LR  - 20200225
IS  - 1471-2377 (Electronic)
IS  - 1471-2377 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Aug 9
TI  - Extensive immune reconstitution inflammatory syndrome in Fingolimod-associated 
      PML: a case report with 7 Tesla MRI data.
PG  - 190
LID - 10.1186/s12883-019-1407-2 [doi]
LID - 190
AB  - BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare 
      complication of patients treated with fingolimod. CASE PRESENTATION: Routine MRI 
      eventually led to diagnosis of asymptomatic early PML that remained stable after 
      discontinuation of fingolimod. As blood lymphocyte counts normalized, signs of 
      immune reconstitution inflammatory syndrome (IRIS) and renewed MS activity 
      developed. Both, advanced laboratory and ultrahigh field MRI findings elucidated 
      differences between PML and MS. CONCLUSIONS: In our case, early discontinuation 
      of fingolimod yielded a good outcome, lymphocyte counts reflected immune system 
      activity, and paraclinical findings helped to differentiate between PML-IRIS and 
      MS.
FAU - Sinnecker, Tim
AU  - Sinnecker T
AD  - Department of Neurology, Universitatsspital, Basel, Switzerland.
AD  - Medical Image Analysis Center Basel, Basel, Switzerland.
FAU - Hadisurya, Jeffrie
AU  - Hadisurya J
AD  - Department of Neurology, Alfried Krupp von Bohlen und Halbach Hospital, 
      Alfried-Krupp-Str. 21, 45117, Essen, Germany.
FAU - Schneider-Hohendorf, Tilman
AU  - Schneider-Hohendorf T
AD  - Clinic of Neurology with Institute of Translational Neurology, University 
      Hospital Munster, Munster, Germany.
FAU - Schwab, Nicholas
AU  - Schwab N
AD  - Clinic of Neurology with Institute of Translational Neurology, University 
      Hospital Munster, Munster, Germany.
FAU - Wrede, Karsten
AU  - Wrede K
AD  - Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, 
      Essen, Germany.
AD  - Erwin L. Hahn Institute for Magnetic Resonance Imaging, University 
      Duisburg-Essen, Essen, Germany.
FAU - Gembruch, Oliver
AU  - Gembruch O
AD  - Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, 
      Essen, Germany.
AD  - Erwin L. Hahn Institute for Magnetic Resonance Imaging, University 
      Duisburg-Essen, Essen, Germany.
FAU - Gold, Ralf
AU  - Gold R
AD  - Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, 
      Germany.
FAU - Hellwig, Kerstin
AU  - Hellwig K
AD  - Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, 
      Germany.
FAU - Pilgram-Pastor, Sara
AU  - Pilgram-Pastor S
AD  - Department of Neuroradiology, Alfried Krupp Hospital, Essen, Germany.
FAU - Adams, Ortwin
AU  - Adams O
AD  - Institute of Virology, Medical Faculty, Heinrich-Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Albrecht, Philipp
AU  - Albrecht P
AD  - Department of Neurology, Medical Faculty, Heinrich-Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Hartung, Hans-Peter
AU  - Hartung HP
AD  - Department of Neurology, Medical Faculty, Heinrich-Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Aktas, Orhan
AU  - Aktas O
AD  - Department of Neurology, Medical Faculty, Heinrich-Heine University Dusseldorf, 
      Dusseldorf, Germany.
FAU - Kraemer, Markus
AU  - Kraemer M
AUID- ORCID: 0000-0002-5667-3621
AD  - Department of Neurology, Alfried Krupp von Bohlen und Halbach Hospital, 
      Alfried-Krupp-Str. 21, 45117, Essen, Germany. 
      markus.kraemer@krupp-krankenhaus.de.
AD  - Department of Neurology, Medical Faculty, Heinrich-Heine University Dusseldorf, 
      Dusseldorf, Germany. markus.kraemer@krupp-krankenhaus.de.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190809
PL  - England
TA  - BMC Neurol
JT  - BMC neurology
JID - 100968555
RN  - 0 (Immunosuppressive Agents)
RN  - G926EC510T (Fingolimod Hydrochloride)
SB  - IM
MH  - Adult
MH  - Fingolimod Hydrochloride/*adverse effects
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnostic imaging
MH  - Immunosuppressive Agents/*adverse effects
MH  - Leukoencephalopathy, Progressive Multifocal/*chemically induced/*diagnostic 
      imaging
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Multiple Sclerosis, Relapsing-Remitting/drug therapy
PMC - PMC6688281
OTO - NOTNLM
OT  - 7 tesla MRI
OT  - Fingolimod
OT  - Immune reconstitution inflammatory syndrome
OT  - Multiple sclerosis
OT  - Progressive multifocal leucencephalopathy
COIS- Tim Sinnecker has received travel support from Roche and Actelion, and is 
      employee of the Medical Image Analysis Center in Basel, Switzerland. Jeffrie 
      Hadisurya has received travel funding from Novartis, Teva, Bayer and Biogen. 
      Tilman Schneider-Hohendorf has received research and travel support from Biogen 
      and Novartis. Nicholas Schwab has received travel funding from Novartis, and 
      Biogen. Karsten Wrede reports no disclosures. Oliver Gembruch reports no 
      disclosures. Ralf Gold received speaker's and board honoraria from Baxter, Bayer 
      Schering, Biogen Idec, CLB Behring, Genzyme, Merck Serono, Novartis, Roche, 
      Stendhal, Talecris, TEVA. His department received grant support from Bayer 
      Schering, BiogenIdec, Genzyme, Merck Serono, Novartis, TEVA. He possesses stock 
      options from Merck Serono and Roche. Kerstin Hellwig reports grants and 
      honoriaria from Biogen, Novartis, Roche, Bayer Healthcare, Teva, Sanofi and 
      Merck. Sara Pilgram-Pastor reports no disclosures. Ortwin Adams reports no 
      disclosures. Philipp Albrecht reports grants, personal fees and non-financial 
      support from Allergan, Biogen, Ipsen, Merz Pharmaceuticals, Novartis, and Roche, 
      personal fees and non-financial support from Bayer Healthcare, and Merck, and 
      non-financial support from Sanofi-Aventis/Genzym. Hans-Peter Hartung has received 
      fees for serving on steering commitees from Biogen Idec, GeNeuro, Sanofi Genzyme, 
      Merck, Novartis Pharmaceuticals, Octapharma, Opexa Therapeutics, Teva 
      Pharmaceuticals, MedImmune, Bayer HealthCare, Forward Pharma, and Roche, fees for 
      serving on advisory boards from Biogen Idec, Sanofi Genzyme, Merck, Novartis 
      Pharmaceuticals, Octapharma, Opexa Therapeutics, Teva Pharmaceuticals, and Roche, 
      and lecture fees from Biogen Idec, Sanofi Genzyme, Merck, Novartis 
      Pharmaceuticals, Octapharma, Opexa Therapeutics, Teva Pharmaceuticals, MedImmune, 
      and Roche. Orhan Aktas has received, with approval by the Heinrich Heine 
      University, advisor fees or honoraria from Almirall, Bayer HealthCare, Biogen, 
      MedImmune, Merck, Novartis, and Teva; research support from Bayer HealthCare, 
      Biogen, Novartis, Roche, and Teva. Markus Kraemer has received, by approval by 
      his hospital, honoria from Bayer Schering, Biogen Idec, Merck Pharma Novartis 
      Pharma, Teva Pharma, Roche Pharma und Shire Deutschland.
EDAT- 2019/08/11 06:00
MHDA- 2019/11/30 06:00
PMCR- 2019/08/09
CRDT- 2019/08/11 06:00
PHST- 2019/03/09 00:00 [received]
PHST- 2019/07/19 00:00 [accepted]
PHST- 2019/08/11 06:00 [entrez]
PHST- 2019/08/11 06:00 [pubmed]
PHST- 2019/11/30 06:00 [medline]
PHST- 2019/08/09 00:00 [pmc-release]
AID - 10.1186/s12883-019-1407-2 [pii]
AID - 1407 [pii]
AID - 10.1186/s12883-019-1407-2 [doi]
PST - epublish
SO  - BMC Neurol. 2019 Aug 9;19(1):190. doi: 10.1186/s12883-019-1407-2.