PMID- 33229808
OWN - NLM
STAT- MEDLINE
DCOM- 20210416
LR  - 20210519
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Print)
IS  - 0918-2918 (Linking)
VI  - 60
IP  - 8
DP  - 2021 Apr 15
TI  - The Effect of Intravenous Methylprednisolone on Recurrent Exacerbation in 
      Hematologic Malignancy-associated Progressive Multifocal Leukoencephalopathy.
PG  - 1287-1291
LID - 10.2169/internalmedicine.5917-20 [doi]
AB  - We herein report a 65-year-old man with progressive multifocal 
      leukoencephalopathy (PML) after 2-year remission from acute myeloid leukemia who 
      developed recurrent episodes of left hemiparesis with gadolinium enhancement on 
      magnetic resonance imaging. Steroid pulse therapy for each exacerbation induced 
      clinical and radiological improvement, suggesting that exacerbations are an 
      excessive immune response to the JC virus and distinct from immune reconstitution 
      inflammatory syndrome (IRIS). Although glucocorticoids are recommended only for 
      IRIS, steroid pulse therapy should be considered as a therapeutic option in cases 
      of exacerbation of hematologic malignancy-associated PML. Importantly, 
      neuroimaging is not sufficient to differentiate excessive inflammation from a 
      controlled inflammatory response, for which steroids are not recommended.
FAU - Nakamura, Ryutaro
AU  - Nakamura R
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Kitamura, Akihiro
AU  - Kitamura A
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Tsukamoto, Takahito
AU  - Tsukamoto T
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Tamura, Ryota
AU  - Tamura R
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Ogawa, Nobuhiro
AU  - Ogawa N
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Yamakawa, Isamu
AU  - Yamakawa I
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Kim, Hyoh
AU  - Kim H
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Kawai, Michihiro
AU  - Kawai M
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Sanada, Mitsuru
AU  - Sanada M
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
FAU - Urushitani, Makoto
AU  - Urushitani M
AD  - Department of Neurology, Shiga University of Medical Science, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20201123
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Aged
MH  - Contrast Media
MH  - Gadolinium
MH  - *Hematologic Neoplasms
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome
MH  - *JC Virus
MH  - *Leukoencephalopathy, Progressive Multifocal/drug therapy
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Methylprednisolone
PMC - PMC8112991
OTO - NOTNLM
OT  - IRIS
OT  - PML
OT  - PML with controlled inflammatory response
OT  - hematologic malignancy-associated PML
OT  - inflammatory PML
COIS- The authors state that they have no Conflict of Interest (COI).
EDAT- 2020/11/25 06:00
MHDA- 2021/04/17 06:00
PMCR- 2021/04/15
CRDT- 2020/11/24 05:57
PHST- 2020/11/25 06:00 [pubmed]
PHST- 2021/04/17 06:00 [medline]
PHST- 2020/11/24 05:57 [entrez]
PHST- 2021/04/15 00:00 [pmc-release]
AID - 10.2169/internalmedicine.5917-20 [doi]
PST - ppublish
SO  - Intern Med. 2021 Apr 15;60(8):1287-1291. doi: 10.2169/internalmedicine.5917-20. 
      Epub 2020 Nov 23.