Acta Neurologica Belgica

, Volume 119, Issue 1, pp 137–139 | Cite as

Tumefactive demyelinating lesions in a patient with multiple sclerosis receiving natalizumab

  • Abdorreza Naser Moghadasi
  • Seyed Mohammad BaghbanianEmail author
Letter to the Editor


Natalizumab has a positive impact on reducing attacks and can also reduce the incidence of new plaques in magnetic resonance imaging (MRI) of multiple sclerosis (MS) patients. However, the complications that have been reported as the side effects of the drug have actually led to restrictions on the use of this drug [1]. Here, a patient is reported with MS who has been suffering from tumefactive demyelinating lesions (TDL) following the consumption of natalizumab.

Case presentation

The patient was a 33-year-old woman on treatment with glatiramer acetate and azathioprine who due to two attacks within a year, her drug was changed to injection of natalizumab 300 mg per month. Four months after the injection of natalizumab, the patient experienced a blurred vision of the left eye. She did not have any clinical symptoms such as dementia, palsy and sensory disturbance. In brain MRI, two TDLs were observed (Fig. 1a, b). The cervical and optic nerve MRI was still normal without...



Multiple sclerosis


Tumefactive demyelinating lesions


Progressive multifocal leukoencephalopathy


Anti-Myelin oligodendrocyte glycoprotein


John Cunningham virus


Human immunodeficiency virus


Lumbar puncture



The authors would like to thank the Sina hospital multiple sclerosis cohort Study group for providing medical records.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the participant included in the study.


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    Twyman C, Berger JR (2010) A giant MS plaque mimicking PML during natalizumab treatment. J Neurol Sci 291(1–2):110–113CrossRefGoogle Scholar
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    Debs R, Maillart E, Fahed R et al (2015) Extensive brain demyelinating lesions under natalizumab: the role of antinatalizumabantibodies. Neurology 85(18):1630–1632CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  1. 1.MS Research Centre, Neuroscience InstituteTehran University of Medical SciencesTehranIran
  2. 2.Sina HospitalTehran University of Medical SciencesTehranIran
  3. 3.Neurology Department, Booalisina HospitalMazandaran University of Medical SciencesSariIran

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