title: Neuroborreliosis during natalizumab treatment in multiple sclerosis.
abstract: We present a case of acute neuroborreliosis in the setting of long-term treatment with natalizumab. A 33-year-old man was diagnosed with relapsing-remitting multiple sclerosis (MS) in 1999. Following failure of various immunomodulatory treatments including interferon and immunoglobulin, he was treated with mitoxantrone from May 2000 to August 2004. Due to persistently high disease activity, he was also treated with cyclophosphamide (December 2005-April 2006) and then azathioprine (April-June 2006), which were both discontinued due to adverse effects. After the patient scored 6.5 on the Expanded Disability Status Scale and had 2 relapses in 2006, we initiated natalizumab therapy (300 mg monthly, starting September 2006). The patient improved significantly in ambulation and the relapse rate slowed as well.
authors.affiliation: From the MS Center, Center of Clinical Neuroscience, Neurological University Clinic Dresden, University Clinic Carl Gustav Carus Dresden, University of Technology Dresden, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Thomas
authors.forename: Thorsten
authors.initials: T
authors.lastname: Schultheiss
authors.forename: Tjalf
authors.initials: T
authors.lastname: Ziemssen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D002443:Ceftriaxone / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D016899:Interferon-beta / Q000276:immunology; D020852:Lyme Neuroborreliosis / Q000139:chemically induced* / Q000188:drug therapy*; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069442:Natalizumab
chemical_list: D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; D000069442:Natalizumab; D002443:Ceftriaxone; D016899:Interferon-beta