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Asymptomatic progressive multifocal leukoencephalopathy during natalizumab therapy with treatment

Fabis-Pedrini, M.J., Xu, W., Burton, J., Carroll, W.M. and Kermode, A.G. (2016) Asymptomatic progressive multifocal leukoencephalopathy during natalizumab therapy with treatment. Journal of Clinical Neuroscience, 25 . pp. 145-147.

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We report a case of asymptomatic progressive multifocal leukoencephalopathy (PML) detected on regular MRI screening in a 40-year-old patient with subsequent benign course with 12 months follow-up. The patient had a history of aggressive inflammatory multiple sclerosis, prior mitoxantrone therapy, Stratify John Cunningham Virus test positivity (Quest Diagnostics, Madison, NJ, USA), and 5 years of natalizumab monotherapy. The initial MRI detection of PML was both atypical and subtle. Early diagnosis and intervention, and pre-emptive treatment for immune reconstitution inflammatory syndrome with high dose steroids, as well as empirical mirtazapine and mefloquine, were associated with a benign PML disease course and outcome.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Churchill Livingstone
Copyright: © 2015 Elsevier Ltd.
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