Neurol Sci (2017) 38:1517–1519 DOI 10.1007/s10072-017-2914-9 LETTER TO THE EDITOR Clinical and MRI improvement in a case of progressive multifocal leukoencephalopathy 1 2 2 3 • • • • Letizia Tirelli Francesca Rosini Alessandra Rufa Guido Garosi 4 1 5 • • Alfonso Cerase Antonio Federico Andrea De Luca Received: 21 February 2017 / Accepted: 13 March 2017 / Published online: 18 April 2017 Springer-Verlag Italia 2017 Dear editor, combination with mirtazapine, an agonist of serotonin-re- ceptor-2A (5HT2AR) blocking the JCV entry into glial Progressive multifocal leukoencephalopathy (PML) is a cells. Although the restoration of host adaptive-immune severe demyelinating CNS disease due to lytic infection of response is the ﬁrst purpose of PML therapy, a paradoxical oligodendrocytes by the John Cunningham polyomavirus excess of immune reconstitution may cause the PML-im- (JCV), an opportunistic agent requiring immunosuppres- mune reconstitution inﬂammatory syndrome (PML-IRIS). sion to become active, commonly complicating HIV In this condition, the administration of intravenous corti- infections, lymphoproliferative disorders or immunosup- costeroids is associated with a more favourable outcome pressive therapies . PML has been reported in immune- . Here we report the ﬁrst PML-IRIS in an SLE patient, mediated rheumatologic disorders, such as systemic lupus responsive to treatment
Neurological Sciences – Springer Journals
Published: Apr 18, 2017
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