1. Extensive immune reconstitution inflammatory syndrome in Fingolimod-associated PML: a case report with 7 Tesla MRI data
- Author
-
Tim Sinnecker, Jeffrie Hadisurya, Tilman Schneider-Hohendorf, Nicholas Schwab, Karsten Wrede, Oliver Gembruch, Ralf Gold, Kerstin Hellwig, Sara Pilgram-Pastor, Ortwin Adams, Philipp Albrecht, Hans-Peter Hartung, Orhan Aktas, and Markus Kraemer
- Subjects
Progressive multifocal leucencephalopathy ,Immune reconstitution inflammatory syndrome ,Fingolimod ,Multiple sclerosis ,7 tesla MRI ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background Progressive multifocal leukoencephalopathy (PML) is a rare complication of patients treated with fingolimod. Case presentation Routine MRI eventually led to diagnosis of asymptomatic early PML that remained stable after discontinuation of fingolimod. As blood lymphocyte counts normalized, signs of immune reconstitution inflammatory syndrome (IRIS) and renewed MS activity developed. Both, advanced laboratory and ultrahigh field MRI findings elucidated differences between PML and MS. Conclusions In our case, early discontinuation of fingolimod yielded a good outcome, lymphocyte counts reflected immune system activity, and paraclinical findings helped to differentiate between PML-IRIS and MS.
- Published
- 2019
- Full Text
- View/download PDF