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Reply: We greatly appreciate the authors' interest in our work and thank them for their contribution to the discussion. Not having encountered a case of immune reconstitution inflammatory syndrome (IRIS) with progressive multifocal leukoencephalopathy (PML) in our institution, we hypothesized possible MR spectroscopic findings in our article, which were confirmed by the authors' communication. The authors' example showed elevated choline and mildly elevated myo-inositol peaks as we postulated in our article in addition to a lactate peak. These spectroscopic abnormalities presumably reflect an intense inflammatory response associated with the PML-IRIS. The baseline MR spectroscopy before development of PML-IRIS helped to elucidate the metabolic changes attributable to PML-IRIS. Related articles in AJNR: Proton MR Spectroscopy of Progressive Multifocal Leukoencephalopathy–Immune Reconstitution Inflammatory Syndrome V. Cuvinciuc, G. Martin-Blondel, B. Marchou, and F. Bonneville AJNR 2010 31: E69-E70. [Full Text] This Article Full Text (PDF) All Versions of this Article: ajnr.A2176v1 31/8/E71 most recent Alert me when this article is cited Alert me if a correction is posted Services Related articles in AJNR Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Bag, A. K. Articles by Shah, R. PubMed Articles by Bag, A. K. Articles by Shah, R. Hotlight (NEW!) What's Hotlight? Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2176
Publisher site
See Article on Publisher Site

Abstract

We greatly appreciate the authors' interest in our work and thank them for their contribution to the discussion. Not having encountered a case of immune reconstitution inflammatory syndrome (IRIS) with progressive multifocal leukoencephalopathy (PML) in our institution, we hypothesized possible MR spectroscopic findings in our article, which were confirmed by the authors' communication. The authors' example showed elevated choline and mildly elevated myo-inositol peaks as we postulated in our article in addition to a lactate peak. These spectroscopic abnormalities presumably reflect an intense inflammatory response associated with the PML-IRIS. The baseline MR spectroscopy before development of PML-IRIS helped to elucidate the metabolic changes attributable to PML-IRIS. Related articles in AJNR: Proton MR Spectroscopy of Progressive Multifocal Leukoencephalopathy–Immune Reconstitution Inflammatory Syndrome V. Cuvinciuc, G. Martin-Blondel, B. Marchou, and F. Bonneville AJNR 2010 31: E69-E70. [Full Text] This Article Full Text (PDF) All Versions of this Article: ajnr.A2176v1 31/8/E71 most recent Alert me when this article is cited Alert me if a correction is posted Services Related articles in AJNR Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Bag, A. K. Articles by Shah, R. PubMed Articles by Bag, A. K. Articles by Shah, R. Hotlight (NEW!) What's Hotlight? Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Sep 1, 2010

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