title: The Risk of Progressive Multifocal Leukoencephalopathy in the Biologic Era: Prevention and Management.
abstract: Progressive multifocal leukoencephalopathy (PML) is a rare, typically fatal, demyelinating central nervous system infection caused by reactivation of the John Cunningham virus that generally occurs in immunosuppressed patients. With an evolving understanding of a greater clinical heterogeneity of PML and significant implications for therapy, PML should be considered in the differential diagnosis of neurologic presentations of rheumatic diseases. Increased awareness of PML among rheumatologists is required, as earlier diagnosis and restoration of immune function may improve the otherwise grim prognosis associated with PML.
authors.affiliation: Department of Rheumatology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: e.molloy@svuh.ie.
authors.forename: Eamonn S
authors.initials: ES
authors.lastname: Molloy
authors.affiliation: RJ Fasenmeyer Center for Clinical Immunology, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Cassandra M
authors.initials: CM
authors.lastname: Calabrese
authors.affiliation: RJ Fasenmeyer Center for Clinical Immunology, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Calabrese
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D012216:Rheumatic Diseases / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents
keywords: Autoimmune rheumatic diseases; Biologic therapy; Progressive multifocal leukoencephalopathy; Rituximab; Synthetic immunosuppressive therapy; Systemic lupus erythematosus