Treatment of Progressive Multifocal Leukoencephalopathy Associated with Natalizumab
2009; Massachusetts Medical Society; Volume: 361; Issue: 11 Linguagem: Inglês
10.1056/nejmoa0810257
ISSN1533-4406
AutoresWerner Wenning, Aiden Haghikia, Jörg Laubenberger, David B. Clifford, Peter F. Behrens, Andrew Chan, Ralf Gold,
Tópico(s)Multiple Sclerosis Research Studies
ResumoWe describe the clinical and therapeutic course of a 52-year-old patient with multiple sclerosis in whom progressive multifocal leukoencephalopathy (PML) developed after 12 months of therapy with natalizumab. The patient was hospitalized 2 months after the onset of neurologic and psychiatric symptoms and was treated with plasma exchange and immunoadsorption to eliminate natalizumab. After a brief improvement, he became critically ill with an apparent episode of immune reconstitution inflammatory syndrome. Steroid-pulse therapy led to stabilization of the patient's condition and clinically significant recovery. This case illustrates that prompt diagnosis and treatment may improve the outcome in patients with severe PML associated with natalizumab therapy.
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