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Updated: May 25, 2026
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Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis
Published on: September 9, 2022
Progressive multifocal leukoencephalopathy in autoimmune diseases.
Elisabeth Palazzo1, Salim Ahmed Yahia
1Service de rhumatologie, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France. elisabeth.palazzo@bch.aphp.fr
Joint Bone Spine
|January 28, 2012
Summary
Progressive multifocal leukoencephalopathy (PML) is a rare but severe brain infection. While often linked to HIV, it can occur in autoimmune patients, particularly those on certain therapies like rituximab.
Area of Science:
- Neuroscience
- Infectious Diseases
- Immunology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by JC virus reactivation.
- PML predominantly affects immunocompromised individuals, including those with HIV/AIDS, hematologic malignancies, and organ transplant recipients.
- PML is increasingly recognized in patients with autoimmune disorders, such as rheumatoid arthritis (RA) and lupus, often associated with specific immunosuppressive treatments.
Purpose of the Study:
- To summarize the occurrence and risk factors of PML in patients with autoimmune diseases, particularly rheumatoid arthritis and lupus.
- To highlight the association between specific therapies, including rituximab and glucocorticoids, and PML development in these patient populations.
- To inform clinicians and patients about the rare but serious risk of PML in the context of managing chronic inflammatory joint diseases.
Main Methods:
- Review of existing literature and case reports detailing PML occurrences in patients with autoimmune disorders.
- Analysis of reported treatment regimens in patients who developed PML.
- Estimation of PML prevalence and risk in specific patient groups, such as RA and lupus patients.
Main Results:
- PML is a rare complication in RA (0.4/100,000) and lupus patients (higher risk than RA).
- Rituximab therapy is associated with an increased PML prevalence in RA patients (4/100,000).
- In lupus patients, PML can occur even with low-dose glucocorticoid therapy without other immunosuppressants.
Conclusions:
- PML is an extremely rare but devastating neurological complication in patients with autoimmune diseases.
- Awareness of PML risk is crucial, especially for RA patients treated with rituximab, who should be informed of this potential complication.
- The risk profile for PML in lupus patients, including those on glucocorticoids, warrants careful consideration.
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