| JC virus persistence following progressive multifocal leukoencephalopathy in multiple sclerosis patients treated with natalizumab. | |
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MedLine Citation:
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PMID: 20818792 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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JC virus (JCV) DNA in the cerebrospinal fluid (CSF) provides the laboratory confirmatory diagnosis of progressive multifocal leukoencephalopathy (PML) in patients whose clinical symptoms and magnetic resonance imaging findings are consistent with PML.The Laboratory of Molecular Medicine and Neuroscience (LMMN), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), made the confirmatory laboratory diagnosis in 35 multiple sclerosis (MS) patients treated with natalizumab. Thirteen patients had 3 or more CSF samples taken from weeks to months following PML diagnosis. Seven of the 13 patients demonstrated persistence of JCV DNA in the CSF even though all patients experienced immune reconstitution inflammatory syndrome (IRIS), 11 patients had plasma exchange, and 2 had immunoabsorption. Specific anti-JCV antibody was measured in plasma/sera samples from 25 of the 35 patients. Most of the samples showed moderate to high or rising antibody levels from the time of PML diagnosis. However, plasma from 1 patient at or near the time of PML diagnosis had a titer considered seronegative and 2 other plasma samples from patients had titers considered at baseline for seropositivity. In several PML cases, viral persistence and neurological deficits have continued for several years, indicating that once initiated, JCV infection may not entirely clear, even with IRIS. |
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Authors:
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Caroline F Ryschkewitsch; Peter N Jensen; Maria Chiara Monaco; Eugene O Major |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Intramural |
Journal Detail:
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Title: Annals of neurology Volume: 68 ISSN: 1531-8249 ISO Abbreviation: Ann. Neurol. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2010-09-24 Revised Date: 2011-04-19 |
Medline Journal Info:
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Nlm Unique ID: 7707449 Medline TA: Ann Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 384-91 Citation Subset: IM |
Affiliation:
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Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies
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blood Antibodies, Monoclonal / therapeutic use* DNA Copy Number Variations / physiology DNA, Viral / blood, cerebrospinal fluid* Enzyme-Linked Immunosorbent Assay / methods Female Humans JC Virus / immunology* Leukoencephalopathy, Progressive Multifocal / drug therapy*, etiology*, metabolism, virology Longitudinal Studies Male Multiple Sclerosis / cerebrospinal fluid, complications*, virology |
| Chemical | |
Reg. No./Substance:
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0/Antibodies; 0/Antibodies, Monoclonal; 0/DNA, Viral; 0/natalizumab |
| Comments/Corrections | |
Comment In:
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Ann Neurol. 2011 Feb;69(2):429-30; author reply 430-1
[PMID:
21246607
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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