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Related Experiment Video

Updated: Mar 10, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
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Progressive multifocal leukoencephalopathy associated with infliximab.

L Sammut1, D Wallis, C Holroyd

  • 1L Sammut, Rheumatology Department, University Hospital Southampton, NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK, E-mail lukesammut@doctors.org.uk.

The Journal of the Royal College of Physicians of Edinburgh
|December 14, 2016
PubMed
Summary

This case report details a patient with rheumatoid arthritis who developed progressive multifocal leukoencephalopathy after infliximab treatment. It highlights a potential association between this biologic therapy and the rare neurological condition.

Keywords:
JC virusinfliximabprogressive multifocal leukoencephalopathyrheumatoid arthritis

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Area of Science:

  • Neuroimmunology
  • Rheumatology
  • Infectious Diseases

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • Biologic therapies like infliximab target inflammatory pathways in RA.
  • Progressive multifocal leukoencephalopathy (PML) is a rare, serious demyelinating disease.

Observation:

  • A 69-year-old female with seropositive RA experienced cognitive decline after infliximab and methotrexate treatment.
  • Cranial MRI revealed demyelinating white matter abnormalities in the frontal and temporal lobes.
  • Brain biopsy confirmed histological changes of PML.

Findings:

  • Cerebrospinal fluid PCR for JC virus was negative.
  • Brain tissue PCR for JC virus was positive.
  • The findings suggest a link between infliximab therapy and PML development in this RA patient.

Implications:

  • This case underscores the importance of monitoring for opportunistic infections, including PML, in RA patients treated with immunosuppressive biologics.
  • It highlights a potential risk associated with infliximab, particularly in patients with autoimmune conditions.
  • Further research may be warranted to elucidate the precise mechanisms and risk factors for PML in this context.