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  • Title: Asymptomatic progressive multifocal leukoencephalopathy during natalizumab therapy with treatment.
    Author: Fabis-Pedrini MJ, Xu W, Burton J, Carroll WM, Kermode AG.
    Journal: J Clin Neurosci; 2016 Mar; 25():145-7. PubMed ID: 26541323.
    Abstract:
    We report a case of asymptomatic progressive multifocal leukoencephalopathy (PML) detected on regular MRI screening in a 40-year-old patient with subsequent benign course with 12 months follow-up. The patient had a history of aggressive inflammatory multiple sclerosis, prior mitoxantrone therapy, Stratify John Cunningham Virus test positivity (Quest Diagnostics, Madison, NJ, USA), and 5 years of natalizumab monotherapy. The initial MRI detection of PML was both atypical and subtle. Early diagnosis and intervention, and pre-emptive treatment for immune reconstitution inflammatory syndrome with high dose steroids, as well as empirical mirtazapine and mefloquine, were associated with a benign PML disease course and outcome.
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