Management and outcome of CSF-JC virus PCR-negative PML in a natalizumab-treated patient with MS.

ABSTRACT:

Objective

To describe the diagnosis and management of a 49-year-old woman with multiple sclerosis (MS) developing a progressive hemiparesis and expanding MRI lesion suspicious of progressive multifocal leukoencephalopathy (PML) 19 months after starting natalizumab.

Results

Polyomavirus JC (JCV)-specific qPCR in CSF was repeatedly negative, but JCV-specific antibodies indicated intrathecal production. Brain biopsy tissue taken 17 weeks after natalizumab discontinuation and plasmapheresis was positive for JCV DNA with characteristic rearrangements of the noncoding control region, but histology and immunohistochemistry were not informative except for pathologic features compatible with immune reconstitution inflammatory syndrome. A total of 22 months later, the clinical status

SUBMITTER: Kuhle J 

PROVIDER: S-EPMC3236516 | biostudies-literature | 2011 Dec

REPOSITORIES: biostudies-literature