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Progressive Multifocal Leukoencephalopathy after Natalizumab Therapy for Crohn's Disease

2005; Massachusetts Medical Society; Volume: 353; Issue: 4 Linguagem: Inglês

10.1056/nejmoa051586

1533-4406

Gert Van Assche, Marc Van Ranst, Raf Sciot, Bénédicte Dubois, Séverine Vermeire, Maja Noman, Jannick Verbeeck, Karel Geboes, Wim Robberecht, Paul Rutgeerts,

RNA Interference and Gene Delivery

The prior diagnosis of fatal astrocytoma in a 60-year-old man with Crohn's disease treated with natalizumab, a monoclonal antibody against alpha4 integrins, was reclassified as JC virus-related progressive multifocal leukoencephalopathy (PML). Analysis of frozen serum samples showed that JC virus DNA had appeared in the serum three months after the initiation of open-label natalizumab monotherapy and two months before the appearance of symptomatic PML. There was staining of the brain lesion for polyomavirus. This case report, along with two others, suggests that anti-alpha4-integrin therapy can result in JC virus-induced PML.