Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction”
Abstract Background Progressive multifocal leukoencephalopathy (PML) is one of the most serious treatment-related complications that is encountered in patients with multiple sclerosis (MS). PML is a serious complication of MS treatment which is most commonly related to natalizumab. Case presentation...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SpringerOpen
2021-01-01
|
Series: | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery |
Subjects: | |
Online Access: | https://doi.org/10.1186/s41983-020-00260-6 |
id |
doaj-72c405a56d2740118ba762d56fe6adbb |
---|---|
record_format |
Article |
spelling |
doaj-72c405a56d2740118ba762d56fe6adbb2021-01-10T12:35:04ZengSpringerOpenThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery1687-83292021-01-015711610.1186/s41983-020-00260-6Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction”Salman Mansoor0Gerard Mullane1Mohammad Hijaz Adenan2Siobhan Kelly3Aine Water4Grainne McPartland5Kevin Murphy6Department of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalDepartment of Neurology, Sligo University HospitalAbstract Background Progressive multifocal leukoencephalopathy (PML) is one of the most serious treatment-related complications that is encountered in patients with multiple sclerosis (MS). PML is a serious complication of MS treatment which is most commonly related to natalizumab. Case presentation We report clinical course of progressive multifocal leukoencephalopathy (PML) in a 40-year-old man who was on treatment for highly active relapsing-remitting multiple sclerosis with natalizumab (Nz). He was treated with steroids, cidofovir, and mirtazapine and went on to develop long-term disability. The case describes the evolution of PML from diagnosis up till 5 months with changes on sequential brain scans and clinical symptoms in our patient. Conclusion Patients who are on natalizumab should be aware and consented for the risk of PML. They should be periodically re-assessed for their relative PML risk. There is a growing body of evidence that suggests switching patients from natalizumab who have a higher risk of PML to other safer treatment options.https://doi.org/10.1186/s41983-020-00260-6NatalizumabProgressive multifocal leukoencephalopathyCidofovirMirtazapineSteroidsMultiple sclerosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Salman Mansoor Gerard Mullane Mohammad Hijaz Adenan Siobhan Kelly Aine Water Grainne McPartland Kevin Murphy |
spellingShingle |
Salman Mansoor Gerard Mullane Mohammad Hijaz Adenan Siobhan Kelly Aine Water Grainne McPartland Kevin Murphy Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Natalizumab Progressive multifocal leukoencephalopathy Cidofovir Mirtazapine Steroids Multiple sclerosis |
author_facet |
Salman Mansoor Gerard Mullane Mohammad Hijaz Adenan Siobhan Kelly Aine Water Grainne McPartland Kevin Murphy |
author_sort |
Salman Mansoor |
title |
Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” |
title_short |
Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” |
title_full |
Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” |
title_fullStr |
Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” |
title_full_unstemmed |
Natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS): “a case report from Ireland with review of literature, clinical pitfalls and future direction” |
title_sort |
natalizumab-associated progressive multifocal leukoencephalopathy (pml) in multiple sclerosis (ms): “a case report from ireland with review of literature, clinical pitfalls and future direction” |
publisher |
SpringerOpen |
series |
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery |
issn |
1687-8329 |
publishDate |
2021-01-01 |
description |
Abstract Background Progressive multifocal leukoencephalopathy (PML) is one of the most serious treatment-related complications that is encountered in patients with multiple sclerosis (MS). PML is a serious complication of MS treatment which is most commonly related to natalizumab. Case presentation We report clinical course of progressive multifocal leukoencephalopathy (PML) in a 40-year-old man who was on treatment for highly active relapsing-remitting multiple sclerosis with natalizumab (Nz). He was treated with steroids, cidofovir, and mirtazapine and went on to develop long-term disability. The case describes the evolution of PML from diagnosis up till 5 months with changes on sequential brain scans and clinical symptoms in our patient. Conclusion Patients who are on natalizumab should be aware and consented for the risk of PML. They should be periodically re-assessed for their relative PML risk. There is a growing body of evidence that suggests switching patients from natalizumab who have a higher risk of PML to other safer treatment options. |
topic |
Natalizumab Progressive multifocal leukoencephalopathy Cidofovir Mirtazapine Steroids Multiple sclerosis |
url |
https://doi.org/10.1186/s41983-020-00260-6 |
work_keys_str_mv |
AT salmanmansoor natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT gerardmullane natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT mohammadhijazadenan natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT siobhankelly natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT ainewater natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT grainnemcpartland natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection AT kevinmurphy natalizumabassociatedprogressivemultifocalleukoencephalopathypmlinmultiplesclerosismsacasereportfromirelandwithreviewofliteratureclinicalpitfallsandfuturedirection |
_version_ |
1724342663213219840 |