A case report of simultaneous PML-IRIS during corticosteroids tapering in a patient with an anti-synthetase syndrome.
We report a case of simultaneous progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-IRIS) during corticosteroid tapering in a patient with an anti-synthetase syndrome. We describe the challenges associated with the diagnosis and the management of this emerging inflammatory neurological condition in this immunocompromised patient with a severe rheumatic disease. We highlight that, in the setting of IRIS, the low-level of the JC virus viral load requires a sensitive PCR assay before excluding PML.
Department of Infectious and Tropical Diseases, Toulouse University Hospital, Toulouse, France ; INSERM UMR 1043, Centre de Physiopathologie, Toulouse-Purpan, France ; Université Toulouse III, Toulouse F-31000, France.
Guillaume
G
Martin-Blondel
INSERM UMR 1043, Centre de Physiopathologie, Toulouse-Purpan, France ; Université Toulouse III, Toulouse F-31000, France ; Department of Neurology, Toulouse University Hospital, Toulouse, France.
David
D
Brassat
Department of Neuroradiology, Toulouse University Hospital, Toulouse, France.
Hervé
H
Dumas
Université Toulouse III, Toulouse F-31000, France ; Department of Pathology, Toulouse University Hospital, Toulouse, France.
Emmanuelle
E
Uro-Coste
Université Toulouse III, Toulouse F-31000, France ; Department of Internal Medicine, Toulouse University Hospital, Toulouse, France.
Daniel
D
Adoue
Center for Brain Research, Medical University of Vienna, Vienna, Austria.
Hans
H
Lassmann
INSERM UMR 1043, Centre de Physiopathologie, Toulouse-Purpan, France ; Université Toulouse III, Toulouse F-31000, France ; Department of Neurology, Toulouse University Hospital, Toulouse, France.
Michel
M
Clanet