Related Experiment Video

Updated: Oct 6, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
26:48

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis

Published on: July 4, 2007

18.9K

Natalizumab-Related Progressive Multifocal Leukoencephalopathy-Immune Reconstitution Inflammatory Syndrome: A Case

Bela Purohit1, Eranga Ganewatte2, Spyros S Kollias2

  • 1Institute for Neuroradiology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland; Dept. of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore-308433.

The Malaysian Journal of Medical Sciences : MJMS
|December 2, 2016
PubMed

Insights

Patients on natalizumab for multiple sclerosis (MS) can develop progressive multifocal leukoencephalopathy (PML) and immune reconstitution inflammatory syndrome (IRIS). Early diagnosis and corticosteroid treatment are crucial for managing these severe natalizumab complications.

Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Natalizumab is a treatment for multiple sclerosis (MS).
  • Progressive multifocal leukoencephalopathy (PML) is a rare but serious complication of natalizumab therapy.
  • Immune reconstitution inflammatory syndrome (IRIS) can occur after natalizumab cessation in PML patients.

Observation:

  • A case of an adult male MS patient on natalizumab for 6 years who developed PML.
  • The patient experienced a paradoxical worsening of PML with IRIS upon natalizumab withdrawal.
  • Magnetic resonance imaging (MRI) revealed inflammatory brain injury consistent with IRIS.

Findings:

  • High-dose corticosteroid therapy led to gradual clinical and radiological improvement.
  • This case highlights the MRI features of natalizumab-associated PML-IRIS.
  • PML and IRIS present significant morbidity and mortality risks.

Implications:

  • Early diagnosis of PML-IRIS is critical for MS patients on natalizumab.
  • Understanding PML-IRIS pathogenesis aids in developing management strategies.
  • Corticosteroids may be effective in managing natalizumab-associated PML-IRIS.
Keywords:
immune reconstitution inflammatory syndromemagnetic resonance imagingmultiple sclerosisnatalizumabprogressive multifocal leukoencephalopathy

More Related Videos

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-409:29

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

Published on: August 21, 2017

12.1K
Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo10:50

Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo

Published on: March 26, 2019

8.4K

Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...