Progressive multifocal leukoencephalopathy with extended natalizumab dosing.

摘要: A 53-year-old man with an 18-year history of multiple sclerosis (MS) was treated natalizumab for 7 years. Two years prior to presentation, treatment interval increased every 6 weeks in attempt reduce the risk PML. Medical notable cutaneous T-cell lymphoma status-post CHOP chemotherapy. JCV serology positive (index 2.8). He presented our tertiary referral center consultation due 8 months progressive left-sided paresthesias, 4 right arm clumsiness, and several expressive aphasia. Neurologic examination consistent these symptoms. Serial brain MRIs demonstrated development a subcortical, multifocal T2/fluid-attenuated inversion recovery hyperintensity left frontoparietal white matter (figure 1). Subtle but definite MRI abnormalities were present same area 12 prior. His clinical course findings prompted urgent evaluation