Document Detail


JC virus persistence following progressive multifocal leukoencephalopathy in multiple sclerosis patients treated with natalizumab.
MedLine Citation:
PMID:  20818792     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Caroline F Ryschkewitsch; Peter N Jensen; Maria Chiara Monaco; Eugene O Major
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Annals of neurology     Volume:  68     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-24     Revised Date:  2011-04-19    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  384-91     Citation Subset:  IM    
Affiliation:
Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
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MeSH Terms
Descriptor/Qualifier:
Antibodies / 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:
0/Antibodies; 0/Antibodies, Monoclonal; 0/DNA, Viral; 0/natalizumab
Comments/Corrections
Comment In:
Ann Neurol. 2011 Feb;69(2):429-30; author reply 430-1   [PMID:  21246607 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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