1. Detection of JC virus archetype in cerebrospinal fluid in a MS patient with dimethylfumarate treatment without lymphopenia or signs of PML.
- Author
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Motte J, Kneiphof J, Straßburger-Krogias K, Klasing A, Adams O, Haghikia A, and Gold R
- Subjects
- Aged, Antibodies, Viral blood, Antibodies, Viral cerebrospinal fluid, DNA, Viral blood, DNA, Viral cerebrospinal fluid, Female, Humans, Multiple Sclerosis, Relapsing-Remitting complications, Polyomavirus Infections complications, Polyomavirus Infections drug therapy, Polyomavirus Infections immunology, Tumor Virus Infections complications, Tumor Virus Infections drug therapy, Tumor Virus Infections immunology, Dimethyl Fumarate therapeutic use, Immunosuppressive Agents therapeutic use, JC Virus genetics, JC Virus immunology, Multiple Sclerosis, Relapsing-Remitting drug therapy, Multiple Sclerosis, Relapsing-Remitting immunology
- Abstract
We report a 76-year-old MS patient, treated with DMF for 3 years. Lymphocytes never showed values below 1240/µl. CSF analysis revealed 1,988,880 copies/ml of JCV-DNA, JCV-DNA was detectable in serum and anti-JCV-antibody in CSF and serum were highly positive. Stratify®-JCV-test was positive. CD8-positive T-lymphocytes were reduced. Therapy with mefloquine, mirtazapine and cidofovir resulted in complete elimination of the virus in serum and 90% reduction of viral load in CSF. This case shows that despite careful monitoring for lymphopenia JCV spreading to the CSF may occur during treatment with DMF.
- Published
- 2018
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