PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation
Background. Natalizumab treatment is frequently discontinued and replaced by alternative medication in multiple sclerosis (MS) patients having a high risk of progressive multifocal leukoencephalopathy (PML). Case Presentation. We report a PML case that was missed on magnetic resonance imaging (MRI)...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/307872 |
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| author | J. Killestein A. Vennegoor A. E. L. van Golde R. L. J. H. Bourez M. L. B. Wijlens M. P. Wattjes |
| author_facet | J. Killestein A. Vennegoor A. E. L. van Golde R. L. J. H. Bourez M. L. B. Wijlens M. P. Wattjes |
| author_sort | J. Killestein |
| collection | DOAJ |
| description | Background. Natalizumab treatment is frequently discontinued and replaced by alternative medication in multiple sclerosis (MS) patients having a high risk of progressive multifocal leukoencephalopathy (PML). Case Presentation. We report a PML case that was missed on magnetic resonance imaging (MRI) at the time Natalizumab treatment was discontinued. The patient subsequently developed a PML-immune reconstitution inflammatory syndrome after the initiation of Fingolimod treatment, suggesting that immune reconstitution may occur even during Fingolimod induced lymphopenia. Conclusion. This report highlights the need for strict drug surveillance using MRI of Natalizumab-associated MS patients at the time of drug discontinuation and beyond. This is important with respect to pharmacovigilance purposes not only for Natalizumab, but also for alternative drugs used after Natalizumab discontinuation. |
| format | Article |
| id | doaj-art-f85e093f652942979065ee688eb5b9c7 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-f85e093f652942979065ee688eb5b9c72025-02-03T01:24:15ZengWileyCase Reports in Neurological Medicine2090-66682090-66762014-01-01201410.1155/2014/307872307872PML-IRIS during Fingolimod Diagnosed after Natalizumab DiscontinuationJ. Killestein0A. Vennegoor1A. E. L. van Golde2R. L. J. H. Bourez3M. L. B. Wijlens4M. P. Wattjes5Department of Neurology, MS Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Neurology, MS Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Neurology, ZGT, Almelo, The NetherlandsDepartment of Radiology, ZGT, Almelo, The NetherlandsDepartment of Neurology, ZGT, Almelo, The NetherlandsDepartment of Radiology, Nuclear Medicine & PET Research, MS Center Amsterdam, VU University Medical Center, Amsterdam, The NetherlandsBackground. Natalizumab treatment is frequently discontinued and replaced by alternative medication in multiple sclerosis (MS) patients having a high risk of progressive multifocal leukoencephalopathy (PML). Case Presentation. We report a PML case that was missed on magnetic resonance imaging (MRI) at the time Natalizumab treatment was discontinued. The patient subsequently developed a PML-immune reconstitution inflammatory syndrome after the initiation of Fingolimod treatment, suggesting that immune reconstitution may occur even during Fingolimod induced lymphopenia. Conclusion. This report highlights the need for strict drug surveillance using MRI of Natalizumab-associated MS patients at the time of drug discontinuation and beyond. This is important with respect to pharmacovigilance purposes not only for Natalizumab, but also for alternative drugs used after Natalizumab discontinuation.http://dx.doi.org/10.1155/2014/307872 |
| spellingShingle | J. Killestein A. Vennegoor A. E. L. van Golde R. L. J. H. Bourez M. L. B. Wijlens M. P. Wattjes PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation Case Reports in Neurological Medicine |
| title | PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation |
| title_full | PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation |
| title_fullStr | PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation |
| title_full_unstemmed | PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation |
| title_short | PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation |
| title_sort | pml iris during fingolimod diagnosed after natalizumab discontinuation |
| url | http://dx.doi.org/10.1155/2014/307872 |
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