Asymptomatic progressive multifocal leukoencephalopathy during natalizumab therapy with treatment

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© 2015 Elsevier Ltd. All rights reserved. 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.
Original languageEnglish
Pages (from-to)145-147
Number of pages3
JournalJournal of Clinical Neuroscience
Early online date4 Jan 2016
Publication statusPublished - 1 Mar 2016


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