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ABS TRACT Aim of this study to describe the clinical and radiological features of a case of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome (PMLIRIS) in a patient with multiple sclerosis treated with natalizumab. A 52 years old man with relapsing-remitting multiple sclerosis was switched disease-modifying therapy from glatiramer acetate to natalizumab because of two serious relapses. PML was developed after his 23rd infusion. Five cures of plasma exchange was given. On the follow up, the clinical picture of the patient was deteriorated. He was treated with 10 doses of intravenous methyprednisolone 1 g/day, followed by oral methyprednisolone treatment. He was partially improved and discharged from the hospital 4 months later with a sequel of left hemiplegia and right 4/5 hemiparesis. After 6 months, the patient died because of some systemic problems such as breath insufficiency secondary to aspiration pneumonia and gastric bleeding although there was not any suspicion of a new neurological attack. Natalizumab treated multiple sclerosis patients with any new magnetic resonance imaging (MRI) lesion, mainly subcortical white matter should suggest PML. Those patients should undergo carefull assessment, including serial clinical and MRI monitoring and cerebrospinal fluid analysis.

türkiye klinikleri nöroloji

Natalizumab Associated Progressive Multifocal Leukoencephalopathy-Immune Reconstitution Inflammatory Syndrome in a Patient with Multiple Sclerosis: Case Report