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       #Post#: 454--------------------------------------------------
       Massive MS exacerbation after withdrawal & early restart of 
       Tysabri
       By: agate Date: September 2, 2014, 8:10 pm
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       This is just one case but it seems significant enough to
       mention. From DocGuide/Neurology, September 2, 2014:
       [quote]Source: J Clin Neurosci
       Massive exacerbation of multiple sclerosis after withdrawal and
       early restart of treatment with natalizumab
       Beume L, Dersch R, Fuhrer H, Stich O, Rauer S, Niesen W;
       Journal of Clinical Neuroscience (Aug 2014)
       We present a 46-year-old woman with a relapse of multiple
       sclerosis (MS) that began 3 months after withdrawal from
       long-term treatment with natalizumab. Shortly after restart of a
       single dose of natalizumab she developed a fulminant MS rebound
       with stupor and tetraparesis. Cerebral MRI showed massive
       progression in the number of lesions and tumefactive lesions
       with ring gadolinium-enhancement. Stereotactic brain biopsy
       revealed acute demyelination and B-cell dominated inflammation.
       The patient improved during therapeutic plasma exchange.
       We speculate that early restart of natalizumab in the case of a
       relapse may worsen disease evolution possibly by modifying
       regulatory immune effector processes during an inflammatory
       rebound phase. A restart of natalizumab in MS patients suffering
       from a recent relapse or with signs of active inflammation
       should be considered with caution.[/quote]
       This article summary can be seen here
  HTML http://www.docguide.com/massive-exacerbation-multiple-sclerosis-after-withdrawal-and-early-restart-treatment-natalizumab?hash=544098a8&eid=40678&alrhash=2e22ec-4b70c95432d7b63d98dcc4c365f92710.
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