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The national incidence of PML in Sweden, 1988–2013
OBJECTIVE: To investigate the incidence of progressive multifocal leukoencephalopathy (PML) and patient characteristics in Sweden between 1988 and 2013. METHODS: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818018/ https://www.ncbi.nlm.nih.gov/pubmed/29321229 http://dx.doi.org/10.1212/WNL.0000000000004926 |
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author | Iacobaeus, Ellen Burkill, Sarah Bahmanyar, Shahram Hakim, Ramil Byström, Camilla Fored, Michael Olsson, Tomas Brundin, Lou Montgomery, Scott |
author_facet | Iacobaeus, Ellen Burkill, Sarah Bahmanyar, Shahram Hakim, Ramil Byström, Camilla Fored, Michael Olsson, Tomas Brundin, Lou Montgomery, Scott |
author_sort | Iacobaeus, Ellen |
collection | PubMed |
description | OBJECTIVE: To investigate the incidence of progressive multifocal leukoencephalopathy (PML) and patient characteristics in Sweden between 1988 and 2013. METHODS: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records. RESULTS: Medical record review classified 108 out of 250 patients (43%) as definite (n = 84), probable (n = 4), or possible (n = 20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients seen in neurology departments) compared with other departments (31%) (p < 0.001). The incidence of PML increased from a largely stable level at 0.026 (95% confidence interval [CI] 0.021–0.031) per 100,000 individuals per year during 1988–2010 to 0.11 (95% CI 083–0.137) during 2011–2013, during which time there was a notable increase (p < 0.001). Hematologic malignancies (n = 34), HIV/AIDS (n = 33), and autoimmune disease (n = 23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients. CONCLUSION: An increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasizes the importance of immediate contact with a neurology center upon suspicion of PML. |
format | Online Article Text |
id | pubmed-5818018 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-58180182018-02-21 The national incidence of PML in Sweden, 1988–2013 Iacobaeus, Ellen Burkill, Sarah Bahmanyar, Shahram Hakim, Ramil Byström, Camilla Fored, Michael Olsson, Tomas Brundin, Lou Montgomery, Scott Neurology Article OBJECTIVE: To investigate the incidence of progressive multifocal leukoencephalopathy (PML) and patient characteristics in Sweden between 1988 and 2013. METHODS: All PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records. RESULTS: Medical record review classified 108 out of 250 patients (43%) as definite (n = 84), probable (n = 4), or possible (n = 20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients seen in neurology departments) compared with other departments (31%) (p < 0.001). The incidence of PML increased from a largely stable level at 0.026 (95% confidence interval [CI] 0.021–0.031) per 100,000 individuals per year during 1988–2010 to 0.11 (95% CI 083–0.137) during 2011–2013, during which time there was a notable increase (p < 0.001). Hematologic malignancies (n = 34), HIV/AIDS (n = 33), and autoimmune disease (n = 23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients. CONCLUSION: An increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasizes the importance of immediate contact with a neurology center upon suspicion of PML. Lippincott Williams & Wilkins 2018-02-06 /pmc/articles/PMC5818018/ /pubmed/29321229 http://dx.doi.org/10.1212/WNL.0000000000004926 Text en © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Iacobaeus, Ellen Burkill, Sarah Bahmanyar, Shahram Hakim, Ramil Byström, Camilla Fored, Michael Olsson, Tomas Brundin, Lou Montgomery, Scott The national incidence of PML in Sweden, 1988–2013 |
title | The national incidence of PML in Sweden, 1988–2013 |
title_full | The national incidence of PML in Sweden, 1988–2013 |
title_fullStr | The national incidence of PML in Sweden, 1988–2013 |
title_full_unstemmed | The national incidence of PML in Sweden, 1988–2013 |
title_short | The national incidence of PML in Sweden, 1988–2013 |
title_sort | national incidence of pml in sweden, 1988–2013 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818018/ https://www.ncbi.nlm.nih.gov/pubmed/29321229 http://dx.doi.org/10.1212/WNL.0000000000004926 |
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