Successful Management of Natalizumab-Associated Progressive Multifocal Leukoencephalopathy and Immune Reconstitution Syndrome in a Patient With Multiple Sclerosis

Alexandra Schröder, De-Hyung Lee, Kerstin Hellwig, Carsten Lukas, Ralf A. Linker, Ralf Gold
2010 Archives of Neurology  
Objective: To describe a case of successful clinical management of natalizumab-associated progressive multifocal leukoencephalopathy (PML) and immune reconstitution syndrome (IRIS) in a patient with multiple sclerosis. Design: Case report. Setting: University hospital. Patient: A 41-year-old woman with relapsingremitting multiple sclerosis developed PML after 29 natalizumab infusions. Interventions: Immediate plasma exchange was combined for removal of natalizumab with application of mefloquine
more » ... and mirtazapine to limit viral replication and oligodendrocyte infection. A subsequent IRIS was treated with glucocorticosteroids.
doi:10.1001/archneurol.2010.157 pmid:20625069 fatcat:o2d5rhj2aja3lkfs3mxx7zohy4