PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation

被引：35

作者：

Killestein, J. ^{[1
]}

Vennegoor, A. ^{[1
]}

van Golde, A. E. L. ^{[2
]}

Bourez, R. L. J. H. ^{[3
]}

Wijlens, M. L. B. ^{[2
]}

Wattjes, M. P. ^{[4
]}

机构：

[1] Vrije Univ Amsterdam, Med Ctr, MS Ctr Amsterdam, Dept Neurol, POB 7057, NL-1007 MB Amsterdam, Netherlands

[2] ZGT, Dept Neurol, Almelo, Netherlands

[3] ZGT, Dept Radiol, Almelo, Netherlands

[4] Vrije Univ Amsterdam, Med Ctr, MS Ctr Amsterdam, Dept Radiol Nucl Med & PET Res, Amsterdam, Netherlands

来源：

CASE REPORTS IN NEUROLOGICAL MEDICINE | 2014年 / 2014卷

关键词：

D O I：

10.1155/2014/307872

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页数：4

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