TY - JOUR
T1 - A giant MS plaque mimicking PML during natalizumab treatment
AU - Twyman, Cary
AU - Berger, Joseph R.
N1 - Funding Information:
Joseph R. Berger, M.D.: Grants and funded studies : Biogen-Idec, EMD-Serono, Genentech, Sanofi-Aventis, and UCB Pharma; Speakers Honoraria : Teva, Bayer, Pfizer, and Serono; Consultant : Teva, Bayer, Merck-Serono, Astellas, Asphelia, Millenium, Genentech, and Glaxo-Smith Kline.
PY - 2010/4/15
Y1 - 2010/4/15
N2 - We describe a patient with a giant MS plaque developing during natalizumab administration whose clinical presentations mimicked PML. This 27 year-old man developed new onset confusion, altered behavior, left hemianesthesia and worsening dysarthria, gait and balance with a new, large, rim-enhancing, temporoparietal subcortical lesion after four infusions of natalizumab. Cerebrospinal JC virus polymerase chain reaction was negative. No neutralizing antibody to natalizumab was detected. Following discontinuation of natalizumab, plasma exchange, and a single dose of 1000 mg of methylprednisolone, he demonstrated clinical and radiographic improvement. Distinguishing PML from MS may be very difficult in some instances. The frequency with which an aggressive demyelinating disorder due to MS occurs during treatment with natalizumab remains to be determined.
AB - We describe a patient with a giant MS plaque developing during natalizumab administration whose clinical presentations mimicked PML. This 27 year-old man developed new onset confusion, altered behavior, left hemianesthesia and worsening dysarthria, gait and balance with a new, large, rim-enhancing, temporoparietal subcortical lesion after four infusions of natalizumab. Cerebrospinal JC virus polymerase chain reaction was negative. No neutralizing antibody to natalizumab was detected. Following discontinuation of natalizumab, plasma exchange, and a single dose of 1000 mg of methylprednisolone, he demonstrated clinical and radiographic improvement. Distinguishing PML from MS may be very difficult in some instances. The frequency with which an aggressive demyelinating disorder due to MS occurs during treatment with natalizumab remains to be determined.
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U2 - 10.1016/j.jns.2010.01.001
DO - 10.1016/j.jns.2010.01.001
M3 - Article
C2 - 20144466
AN - SCOPUS:77349117963
SN - 0022-510X
VL - 291
SP - 110
EP - 113
JO - Journal of the neurological sciences
JF - Journal of the neurological sciences
IS - 1-2
ER -