Journal
MULTIPLE SCLEROSIS AND RELATED DISORDERS
Volume 3, Issue 4, Pages 419-430Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.msard.2014.01.005
Keywords
Progressive rritattifocal leukoencephalopathy; Multiple sclerosis; Natalizumab; JCV; JCV serology; PML-IRIS
Categories
Funding
- Genzyme
- National Multiple Sclerosis Society
- PML Consortium
- Biogenldec
- Millennium
- Genentech
- Amgen
- Eisai
- Novartis
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The natural history and clinical import of Progressive Multifocal Leukoencephalopathy has changed enormously in the last thirty years. After a resurgence of PML during the HIV/AIDS epidemic, advances in the treatment of multiple sclerosis created another group of 'at risk' patients. With a focus on issues pertaining to the multiple sclerosis patient population, this review covers pathophysiology of the JC virus, causes of PML, mechanisms by which natalizumab increases the risk of PML, determinants of PML risk in natalizumab-treated patients, risks of natalizumab discontinuation, PML prevention and surveillance, PML imaging features, PML diagnosis and stumbling blocks to making the diagnosis, PML and PML-Immune Reconstitution Inflammatory Syndrome (IRIS) treatment. (C) 2014 Elsevier B.V. All rights reserved.
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