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Extensive immune reconstitution inflammatory syndrome in Fingolimod-associated PML: a case report with 7 Tesla MRI data

BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare complication of patients treated with fingolimod. CASE PRESENTATION: Routine MRI eventually led to diagnosis of asymptomatic early PML that remained stable after discontinuation of fingolimod. As blood lymphocyte counts normalize...

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Detalles Bibliográficos
Autores principales: Sinnecker, Tim, Hadisurya, Jeffrie, Schneider-Hohendorf, Tilman, Schwab, Nicholas, Wrede, Karsten, Gembruch, Oliver, Gold, Ralf, Hellwig, Kerstin, Pilgram-Pastor, Sara, Adams, Ortwin, Albrecht, Philipp, Hartung, Hans-Peter, Aktas, Orhan, Kraemer, Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688281/
https://www.ncbi.nlm.nih.gov/pubmed/31399069
http://dx.doi.org/10.1186/s12883-019-1407-2
Descripción
Sumario:BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare complication of patients treated with fingolimod. CASE PRESENTATION: Routine MRI eventually led to diagnosis of asymptomatic early PML that remained stable after discontinuation of fingolimod. As blood lymphocyte counts normalized, signs of immune reconstitution inflammatory syndrome (IRIS) and renewed MS activity developed. Both, advanced laboratory and ultrahigh field MRI findings elucidated differences between PML and MS. CONCLUSIONS: In our case, early discontinuation of fingolimod yielded a good outcome, lymphocyte counts reflected immune system activity, and paraclinical findings helped to differentiate between PML-IRIS and MS.