Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 25, Issue -, Pages 145-147Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2015.08.027
Keywords
Immune reconstitution inflammatory syndrome; Multiple sclerosis; Natalizumab; Progressive multifocal leukoencephalopathy
Categories
Funding
- Sun Yat Sen University Occupational Training Scholarship
- International Project Fund of 985 Project
- Sun Yat Sen University
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We report a case of asymptomatic progressive multifocal leukoencephalopathy (PML) detected on regular MRI screening in a 40-year-old patient with subsequent benign course with 12 months follow-up. The patient had a history of aggressive inflammatory multiple sclerosis, prior mitoxantrone therapy, Stratify John Cunningham Virus test positivity (Quest Diagnostics, Madison, NJ, USA), and 5 years of natalizumab monotherapy. The initial MRI detection of PML was both atypical and subtle. Early diagnosis and intervention, and pre-emptive treatment for immune reconstitution inflammatory syndrome with high dose steroids, as well as empirical mirtazapine and mefloquine, were associated with a benign PML disease course and outcome. (C) 2015 Elsevier Ltd. All rights reserved.
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