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Erschienen in: Journal of Neurology 6/2014

01.06.2014 | Original Communication

Diagnosis of asymptomatic natalizumab-associated PML: are we between a rock and a hard place?

verfasst von: Mike P. Wattjes, Anke Vennegoor, Jop Mostert, Bob W. van Oosten, Frederik Barkhof, Joep Killestein

Erschienen in: Journal of Neurology | Ausgabe 6/2014

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Abstract

The diagnosis of natalizumab-associated progressive multifocal leukoencephalopathy (PML) in multiple sclerosis patients in an asymptomatic stage is crucial since it is associated with better clinical outcome measures. Current diagnostic criteria on PML diagnosis in asymptomatic patients require the detection of JC virus and corresponding imaging findings. Magnetic resonance imaging (MRI) is the most sensitive diagnostic method for these purposes. However, the diagnosis of asymptomatic natalizumab-associated PML based on MRI findings can be challenging particularly in case of inconclusive or negative results on JC virus detection in the cerebrospinal fluid. In this report, we present a case series demonstrating different diagnostic scenarios of asymptomatic PML diagnosis based on MRI findings in combination with inconclusive or negative results on JC virus detection in the cerebrospinal fluid. We discuss the challenges of applying current PML diagnostic criteria in asymptomatic natalizumab-associated PML patients and stress the need for specific diagnostic criteria and guidelines regarding managing these diagnostic dilemmas in order to facilitate an early and correct diagnosis of PML presumably leading to a better clinical outcome.
Literatur
1.
Zurück zum Zitat Rudick R, Polman C, Clifford D, Miller D et al (2013) Natalizumab: bench to bedside and beyond. JAMA Neurol 70:172–182CrossRefPubMed Rudick R, Polman C, Clifford D, Miller D et al (2013) Natalizumab: bench to bedside and beyond. JAMA Neurol 70:172–182CrossRefPubMed
2.
Zurück zum Zitat Berger JR, Aksamit AJ, Clifford DB et al (2013) PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section. Neurology 80:1430–1438PubMedCentralCrossRefPubMed Berger JR, Aksamit AJ, Clifford DB et al (2013) PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section. Neurology 80:1430–1438PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Mentzer D, Prestel J, Adams O et al (2012) Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies. J Neurol Neurosurg Psychiatry 83:927–933CrossRefPubMed Mentzer D, Prestel J, Adams O et al (2012) Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies. J Neurol Neurosurg Psychiatry 83:927–933CrossRefPubMed
4.
Zurück zum Zitat Yousry TA, Pelletier D, Cadavid D et al (2012) MRI pattern in natalizumab-associated progressive multifocal leukoencephalopathy. Ann Neurol 72:779–787CrossRefPubMed Yousry TA, Pelletier D, Cadavid D et al (2012) MRI pattern in natalizumab-associated progressive multifocal leukoencephalopathy. Ann Neurol 72:779–787CrossRefPubMed
5.
Zurück zum Zitat Wattjes MP, Richert ND, Killestein J et al (2013) The chameleon of neuroinflammation: magnetic resonance imaging characteristics of natalizumab-associated progressive multifocal leukoencephalopathy. Mult Scler 19:1826–1840CrossRefPubMed Wattjes MP, Richert ND, Killestein J et al (2013) The chameleon of neuroinflammation: magnetic resonance imaging characteristics of natalizumab-associated progressive multifocal leukoencephalopathy. Mult Scler 19:1826–1840CrossRefPubMed
6.
Zurück zum Zitat Blair NF, Brew BJ, Halpern JP (2012) Natalizumab-associated PML identified in the presymptomatic phase using MRI surveillance. Neurology 78:507–508CrossRefPubMed Blair NF, Brew BJ, Halpern JP (2012) Natalizumab-associated PML identified in the presymptomatic phase using MRI surveillance. Neurology 78:507–508CrossRefPubMed
7.
Zurück zum Zitat Havla J, Hohlfeld R, Kümpfel T (2014) Unusual natalizumab-associated progressive multifocal leukoencephalopathy starting in the brainstem. J Neurol 261:232–234CrossRefPubMed Havla J, Hohlfeld R, Kümpfel T (2014) Unusual natalizumab-associated progressive multifocal leukoencephalopathy starting in the brainstem. J Neurol 261:232–234CrossRefPubMed
8.
Zurück zum Zitat Phan-Ba R, Lommers E, Tshibanda L et al (2012) MRI preclinical detection and asymptomatic course of a progressive multifocal leukoencephalopathy (PML) under natalizumab therapy. J Neurol Neurosurg Psychiatry 83:224–226CrossRefPubMed Phan-Ba R, Lommers E, Tshibanda L et al (2012) MRI preclinical detection and asymptomatic course of a progressive multifocal leukoencephalopathy (PML) under natalizumab therapy. J Neurol Neurosurg Psychiatry 83:224–226CrossRefPubMed
9.
Zurück zum Zitat Lindå H, von Heijne A (2013) Presymptomatic diagnosis with MRI and adequate treatment ameliorate the outcome after natalizumab-associated progressive multifocal leukoencephalopathy. Front Neurol 4:11PubMedCentralCrossRefPubMed Lindå H, von Heijne A (2013) Presymptomatic diagnosis with MRI and adequate treatment ameliorate the outcome after natalizumab-associated progressive multifocal leukoencephalopathy. Front Neurol 4:11PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Dong-Si T, Richman S, Bloomgren G et al (2013) Survival and functional outcome in asymptomatic natalizumab-associated progressive multifocal leukoencephalopathy multiple sclerosis patients. Mult Scler 19: (S1) P879 Presented at ECTRIMS Copenhagen, 2013 Dong-Si T, Richman S, Bloomgren G et al (2013) Survival and functional outcome in asymptomatic natalizumab-associated progressive multifocal leukoencephalopathy multiple sclerosis patients. Mult Scler 19: (S1) P879 Presented at ECTRIMS Copenhagen, 2013
11.
Zurück zum Zitat Ryschkewitsch CF, Jensen PN, Monaco MC, Major EO (2010) JC virus persistence following progressive multifocal leukoencephalopathy in multiple sclerosis patients treated with natalizumab. Ann Neurol 68:384–391PubMedCentralCrossRefPubMed Ryschkewitsch CF, Jensen PN, Monaco MC, Major EO (2010) JC virus persistence following progressive multifocal leukoencephalopathy in multiple sclerosis patients treated with natalizumab. Ann Neurol 68:384–391PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat Kuhle J, Gosert R, Bühler R et al (2011) Management and outcome of CSF-JC virus PCR-negative PML in a natalizumab-treated patient with MS. Neurology 77:2010–2016PubMedCentralCrossRefPubMed Kuhle J, Gosert R, Bühler R et al (2011) Management and outcome of CSF-JC virus PCR-negative PML in a natalizumab-treated patient with MS. Neurology 77:2010–2016PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Fine AJ, Sorbello A, Kortepeter C, Scarazzini L (2014) Progressive multifocal leukoencephalopathy after natalizumab discontinuation. Ann Neurol 75:108–115CrossRefPubMed Fine AJ, Sorbello A, Kortepeter C, Scarazzini L (2014) Progressive multifocal leukoencephalopathy after natalizumab discontinuation. Ann Neurol 75:108–115CrossRefPubMed
14.
Zurück zum Zitat Wattjes MP, Killestein J (2014) PML after natalizumab discontinuation: few and true? Ann Neurol 75:462 Wattjes MP, Killestein J (2014) PML after natalizumab discontinuation: few and true? Ann Neurol 75:462
15.
Zurück zum Zitat Warnke C, Markwerth P, Pawlita M et al (2013) The anti-JC virus antibody index in CSF for diagnosis of progressive multifocal leukoencephalopathy (PML) in patients with multiple sclerosis. Mult Scler (S1): 181. Presented at ECTRIMS Copenhagen, 2013 Warnke C, Markwerth P, Pawlita M et al (2013) The anti-JC virus antibody index in CSF for diagnosis of progressive multifocal leukoencephalopathy (PML) in patients with multiple sclerosis. Mult Scler (S1): 181. Presented at ECTRIMS Copenhagen, 2013
Metadaten
Titel
Diagnosis of asymptomatic natalizumab-associated PML: are we between a rock and a hard place?
verfasst von
Mike P. Wattjes
Anke Vennegoor
Jop Mostert
Bob W. van Oosten
Frederik Barkhof
Joep Killestein
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 6/2014
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-014-7336-5

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