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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 mefloquinedoi:10.1001/archneurol.2010.157 pmid:20625069 fatcat:o2d5rhj2aja3lkfs3mxx7zohy4