title: Herpes encephalitis during natalizumab treatment in multiple sclerosis.
abstract: In this case report we describe the first non-fatal herpes simplex virus encephalitis (HSE) case with natalizumab for multiple sclerosis (MS). A 36-year-old woman, previously treated with immunomodulatory and immunosuppressive drugs for MS, developed acute encephalitis after 6 monthly natalizumab perfusions. Brain imaging demonstrated suggestive bi-temporal lesions. Herpes simplex virus type-1 DNA was detected in cerebrospinal fluid. The patient improved gradually after a 21-day course of intravenous acyclovir, but neuropsychiatric changes remained 5 months later. Our non-fatal case of HSE and other reported cases of herpes infections provide evidence of an increased risk with natalizumab and point to the need for clinicians to maintain awareness.
authors: PRES Lille Nord de France, Université Catholique de Lille, Groupe Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine, Clinique de Neurologie, Lille, France. kwiatkowski.arnaud@ghicl.net
authors: A
authors: A
authors: Kwiatkowski
authors: J
authors: J
authors: Gallois
authors: N
authors: N
authors: Bilbault
authors: G
authors: G
authors: Calais
authors: A
authors: A
authors: Mackowiak
authors: P
authors: P
authors: Hautecoeur
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000998:Antiviral Agents / Q000008:administration & dosage; D003071:Cognition / Q000187:drug effects; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D004334:Drug Administration Schedule; D020803:Encephalitis, Herpes Simplex / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D005260:Female; D018259:Herpesvirus 1, Human / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008568:Memory / Q000187:drug effects; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D000069442:Natalizumab; D013997:Time Factors; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D004279:DNA, Viral; D007155:Immunologic Factors; D000069442:Natalizumab; D000212:Acyclovir