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Progressive multifocal leukoencephalopathy

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Case Studies in Multiple Sclerosis
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Abstract

While out-of-town visiting family, a 54-year-old female previously diagnosed with relapsing-remitting multiple sclerosis (RRMS) presented to the clinic as a new patient to be evaluated for a recent exacerbation, manifesting with abrupt onset of constant, mild vertigo, and increasingly frequent falls, with progressive deterioration over the last 6 weeks. She also had some mild nausea, but denied any emesis or weight loss. There were no cognitive, personality, or behavioral changes reported.

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References

  1. Cordioli C, De Rossi N, Rasia S, Lodoli G, Capra R. Early detection and favourable outcome of natalizumab-related progressive multifocal leukoencephalopathy (PML) in two multiple sclerosis patients. Neurol Sci. 2015;36:489-491.

    Google Scholar 

  2. Wattjes MP, Barkhof F. Diagnosis of natalizumab-associated progressive multifocal leukoencephalopathy using MRI. Curr Opin Neurol. 2014;27:260-270.

    Google Scholar 

  3. Babi M-A, Pendlebury W, Braff S, Waheed W. JC Virus PCR detection Is not infallible: a fulminant case of progressive multifocal leukoencephalopathy with false-negative cerebrospinal fluid studies despite progressive clinical course and radiological findings. Case Rep Neurol Med. 2015;2015:4.

    Google Scholar 

  4. Rudick RA, Sandrock A. Natalizumab: alpha 4-integrin antagonist selective adhesion molecule inhibitors for MS. Expert Rev Neurother. 2004;4:571-580.

    Google Scholar 

  5. Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH, et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med. 2006;354:899-910.

    Google Scholar 

  6. Rudick RA, Stuart WH, Calabresi PA, et al. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med. 2006;354:911-923.

    Google Scholar 

  7. Bloomgren G, Richman S, Hotermans C, et al. Risk of natalizumab-associated progressive multifocal leukoencephalopathy. N Engl J Med. 2012;366:1870-1880.

    Google Scholar 

  8. Engsig FN, Hansen A-BE, Omland LH, et al. Incidence, clinical presentation, and outcome of progressive multifocal leukoencephalopathy in HIV-infected patients during the highly active antiretroviral therapy era: a nationwide cohort study. J Infect Dis. 2009;199:77-83.

    Google Scholar 

  9. Sahraian MA, Radue EW, Eshaghi A, Besliu S, Minagar A. Progressive multifocal leukoencephalopathy: a review of the neuroimaging features and differential diagnosis. Eur J Neurol. 2012;19:1060-1069.

    Google Scholar 

  10. Khatri BO, Man S, Giovannoni G, et al. Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte function. Neurology. 2009;72:402-409.

    Google Scholar 

  11. Rushing EJ, Liappis A, Smirniotopoulos JD, et al. Immune reconstitution inflammatory syndrome of the brain: case illustrations of a challenging entity. J Neuropathol Exp Neurol. 2008;67:819-827.

    Google Scholar 

  12. Giacomini PS, Rosenberg A, Metz I, Araujo D, Arbour N, Bar-Or A; MIMSTAPI group. Maraviroc and JCvirus-associated immune reconstitution inflammatory syndrome. N Engl J Med. 2014; 370:486-488.

    Google Scholar 

  13. Clifford DB, De Luca A, Simpson DM, Arendt G, Giovannoni G, Nath A. Natalizumabassociated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: lessons from 28 cases. Lancet Neurol. 2010;9:438-446.

    Google Scholar 

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Eckstein, C. (2017). Progressive multifocal leukoencephalopathy. In: Giacomini, P. (eds) Case Studies in Multiple Sclerosis. Adis, Cham. https://doi.org/10.1007/978-3-319-31190-6_6

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  • DOI: https://doi.org/10.1007/978-3-319-31190-6_6

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-31188-3

  • Online ISBN: 978-3-319-31190-6

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