PMID- 36946407
OWN - NLM
STAT- MEDLINE
DCOM- 20230323
LR  - 20230323
IS  - 1997-7298 (Print)
IS  - 1997-7298 (Linking)
VI  - 123
IP  - 3
DP  - 2023
TI  - [Differential diagnosis of immune reconstitution inflammatory syndrome and 
      progressive multifocal leukoencephalopathy after natalizumab withdrawal].
PG  - 116-121
LID - 10.17116/jnevro2023123031116 [doi]
AB  - The appearance of new foci on MRI, the increase in neurological deficits, 
      including the appearance of cognitive disorders and disturbances in the level of 
      consciousness in patients with multiple sclerosis during the <<washing period>> 
      when transferring from natalizumab (NZ) to another drug, may be due to both 
      progressive multifocal leukoencephalopathy (PML) and exacerbation of the disease 
      in the absence of therapy. Discontinuation of NS is fraught not only with a 
      resumption, but with an increase in disease activity, the development of an 
      immune reconstitution inflammatory syndrome (IRIS) due to the opening of the 
      blood-brain barrier. Often, the processes of differential diagnosis of IRIS and 
      natalizumab-associated PML are complex and require the use of additional methods 
      of examination and monitoring of the dynamics of the patient's condition. 
      However, the severity of the condition and the severity of the consequences 
      caused by incorrect therapeutic tactics significantly reduce the time for 
      diagnosis and require an immediate decision. The difficulties of differential 
      diagnosis of IRIS and PML are reflected in the clinical case.
FAU - Yakushina, T I
AU  - Yakushina TI
AUID- ORCID: 0000-0002-2245-039X
AD  - Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
FAU - Yakushin, D M
AU  - Yakushin DM
AUID- ORCID: 0000-0001-9540-1859
AD  - Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
FAU - Shtang, I O
AU  - Shtang IO
AUID- ORCID: 0000-0003-0355-9443
AD  - Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
LA  - rus
PT  - English Abstract
PT  - Journal Article
TT  - Differentsial'naya diagnostika vospalitel'nogo sindroma vosstanovleniya 
      immuniteta i progressiruyushchei mul'tifokal'noi entsefalopatii pri otmene 
      natalizumaba.
PL  - Russia (Federation)
TA  - Zh Nevrol Psikhiatr Im S S Korsakova
JT  - Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
JID - 9712194
RN  - 0 (Natalizumab)
RN  - 0 (Antibodies, Monoclonal, Humanized)
SB  - IM
MH  - Humans
MH  - Natalizumab/adverse effects
MH  - *Leukoencephalopathy, Progressive Multifocal/diagnosis/diagnostic imaging
MH  - Diagnosis, Differential
MH  - *Immune Reconstitution Inflammatory Syndrome/diagnosis/drug therapy/etiology
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - *Multiple Sclerosis/diagnosis
OTO - NOTNLM
OT  - discontinuation of natalizumab therapy
OT  - immune reconstitution inflammatory syndrome (IRIS)
OT  - multiple sclerosis
OT  - progressive multifocal leukoencephalopathy (PML)
EDAT- 2023/03/23 06:00
MHDA- 2023/03/24 06:00
CRDT- 2023/03/22 07:08
PHST- 2023/03/22 07:08 [entrez]
PHST- 2023/03/23 06:00 [pubmed]
PHST- 2023/03/24 06:00 [medline]
AID - 10.17116/jnevro2023123031116 [doi]
PST - ppublish
SO  - Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(3):116-121. doi: 
      10.17116/jnevro2023123031116.