title: JC virus granule cell neuronopathy and GCN-IRIS under natalizumab treatment.
abstract: Progressive multifocal leukoencephalopathy is the most common clinical presentation of JC virus (JCV)-associated central nervous system (CNS) disease and has emerged as a major safety concern in multiple sclerosis patients treated with the monoclonal antibody natalizumab. Here we report clinical, radiological, and histological findings of a case of cerebellar granule cell neuronopathy (GCN), a JCV-associated CNS disease, so far unreported amongst patients treated with natalizumab. GCN should be considered as a JCV CNS manifestation in patients with newly developed, progressive cerebellar signs under natalizumab treatment, especially in cases where cerebellar atrophy can be visualized by magnetic resonance imaging.
authors.affiliation: Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University Hospital Zurich, Zurich; Department of Neurology, University Hospital Zurich, Zurich.
authors.forename: Sven
authors.initials: S
authors.lastname: Schippling
authors.forename: Christian
authors.initials: C
authors.lastname: Kempf
authors.forename: Fabian
authors.initials: F
authors.lastname: Büchele
authors.forename: Ivan
authors.initials: I
authors.lastname: Jelcic
authors.forename: Oliver
authors.initials: O
authors.lastname: Bozinov
authors.forename: Adriano
authors.initials: A
authors.lastname: Bont
authors.forename: Michael
authors.initials: M
authors.lastname: Linnebank
authors.forename: Mireia
authors.initials: M
authors.lastname: Sospedra
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.forename: Herbert
authors.initials: H
authors.lastname: Budka
authors.forename: Roland
authors.initials: R
authors.lastname: Martin
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D015703:Antigens, CD / Q000378:metabolism; D001921:Brain / Q000473:pathology / Q000821:virology; D005260:Female; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology* / Q000473:pathology / Q000821:virology; D007577:JC Virus / Q000502:physiology*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications* / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D000069442:Natalizumab; D013132:Spinocerebellar Degenerations / Q000188:drug therapy / Q000209:etiology*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D015703:Antigens, CD; D000069442:Natalizumab