Brief report - Progressive multifocal leukoencephalopathy complicating treatment with natalizumab and interferon beta-1a for multiple sclerosis
Brief report - Progressive multifocal leukoencephalopathy complicating treatment with natalizumab and interferon beta-1a for multiple sclerosis
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DOI：
10.1056/nejmoa051782
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发表时间：
2005-07-28
影响因子：
158.5
通讯作者：
Tyler, KL
中科院分区：
文献类型：
--
作者：
Kleinschmidt-DeMasters, BK;Tyler, KL
一名46岁的复发缓解型多发性硬化症女性在接受了37剂那他珠单抗（每四周300 mg）治疗后死于进行性多灶性白质脑病（PM），这是那他珠单抗和干扰素β-1a临床试验的一部分。根据聚合酶链反应试验在脑脊液中发现JC病毒DNA诊断PML，并在尸检中得到证实。几乎所有来自双侧大脑半球的组织切片都含有肉眼或显微镜下的PML病变。左侧额顶区有广泛的组织破坏和空洞，大量奇异的星形胶质细胞和含包涵体的少突胶质细胞，原位杂交显示JC病毒DNA阳性。
A 46-year-old woman with relapsing-remitting multiple sclerosis died from progressive multifocal leukoencephalopathy (PM) after having received 37 doses of natalizumab (300 mg every four weeks) as part of a clinical trial of natalizumab and interferon beta-1a. PML was diagnosed on the basis of the finding of JC viral DNA in cerebrospinal fluid on polymerase-chain-reaction assay and was confirmed at autopsy. Nearly every tissue section from bilateral cerebral hemispheres contained either macroscopic or microscopic PML lesions. There was extensive tissue destruction and cavitation in the left frontoparietal area, large numbers of bizarre astrocytes, and inclusion-bearing oligodendrocytes, which were positive for JC virus DNA on in situ hybridization.