title: Presumptive progressive multifocal leukoencephalopathy in multiple sclerosis after natalizumab therapy.
abstract: OBJECTIVE
  To describe a patient with relapsing remitting MS who was treated with natalizumab for 36 months. First symptoms of presumptive progressive multifocal leukoencephalopathy (PML) appeared 14 weeks after her last natalizumab infusion.
  
  
  METHODS
  Neurological examination, MRI and CSF analysis were performed.
  
  
  RESULTS
  The lack of anti-inflammatory treatment response, clinical course, and serial MRI examinations showed lesion development typical for PML on diffusion-weighted and FLAIR MRI. CSF analysis for JC virus was tested negative twice.
  
  
  CONCLUSIONS
  This case represents a presumptive PML after discontinuation of natalizumab treatment-similar to the definition established for PML in HIV patients.
authors: Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Germany.
authors: Philipp
authors: P
authors: Eisele
authors: Kristina
authors: K
authors: Szabo
authors: Eva
authors: E
authors: Hornberger
authors: Martin
authors: M
authors: Griebe
authors: Michael G
authors: MG
authors: Hennerici
authors: Bernd C
authors: BC
authors: Kieseier
authors: Achim
authors: A
authors: Gass
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009103:Multiple Sclerosis; D000069442:Natalizumab
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab
keywords: Progressive multifocal leukoencephalopathy; multiple sclerosis; natalizumab