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#Post#: 886--------------------------------------------------
(Abst.) [Early identification of PML in patients on Tysabri]
By: agate Date: August 3, 2015, 7:39 pm
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From PubMed via the MS International Federation News, July 27,
2015:
[quote]J Neurol Neurosurg Psychiatry. 2015 Jul;86(7):793-8.
MRI pattern in asymptomatic natalizumab-associated PML
Wattjes MP1, Vennegoor A2, Steenwijk MD1, de Vos M1, Killestein
J2, van Oosten BW2, Mostert J3, Siepman DA4, Moll W5, van Golde
AE6, Frequin ST7, Richert ND8, Barkhof F1.
Author information
1Department of Radiology and Nuclear Medicine, MS Center
Amsterdam, VU University Medical Center, Amsterdam, The
Netherlands.
2Department of Neurology, MS Center Amsterdam, VU University
Medical Center, Amsterdam, The Netherlands.
3Department of Neurology, Rijnstate Hospital, Arnhem, The
Netherlands.
4Department of Neurology, Erasmus MC, University Medical Center
Rotterdam, MS Center, Rotterdam, The Netherlands.
5Department of Neurology, Maasstad Hospital, Rotterdam, The
Netherlands.
6Department of Neurology, GT Hospital Almelo, Almelo, The
Netherlands.
7Department of Neurology, St. Antonius Hospital, Nieuwegein, The
Netherlands.
8Multiple Sclerosis Clinical Development Group, Biogen Idec,
Cambridge, Massachusetts, USA.
OBJECTIVE:
To investigate the MRI manifestation pattern of asymptomatic
natalizumab-associated progressive multifocal
leukoencephalopathy (PML) in patients with multiple sclerosis
(MS).
METHODS:
18 patients with MS with natalizumab-associated PML lesions on
MRI were included. In 6 patients, the PML lesions were
identified on MRI prospectively and in 12 patients PML lesions
were identified retrospectively. MRI sequences were analysed for
PML lesion distribution, appearance, grey matter/white matter
involvement and possible signs of inflammation. Lesion
probability maps were created to demonstrate lesion distribution
pattern.
RESULTS:
The frontal lobe was involved in 14 patients (77.8%) and the
parietal lobe in 4 patients (22.2%). Most patients presented
with focal lesions (13 patients, 72.2%) involving one single
lobe (12 patients, 66.7%). The cortical grey matter was affected
in 15 patients (83.3%) and 13 patients (72.2%) presented with a
combination of cortical grey and white matter involvement. Signs
of inflammation were detected in 7 patients (38.8%). Among
patients with available diffusion-weighted imaging, 6 patients
(40%) did not show high-signal-intensity lesions. A classical
imaging pattern including unilateral and unilobar focal lesions
in the frontal lobe affecting the cortical grey matter or the
cortical grey and adjacent white matter was observed in 8
patients (44.4%).
CONCLUSIONS:
Asymptomatic natalizumab-associated PML manifestations on MRI
show a rather localised disease, frequently located in the
frontal lobes, affecting the cortical grey matter and adjacent
juxtacortical white matter. Awareness of this lesion pattern
facilitates an earlier diagnosis of natalizumab-associated PML
in an asymptomatic stage associated with a more favourable
prognosis.
[/quote]
The abstract can be seen here
HTML http://www.ncbi.nlm.nih.gov/pubmed/25205744.
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