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Updated: May 11, 2026

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
A first report of progressive multifocal leukoencephalopathy in childhood-onset NMOSD
Pakeeran Siriratnam1,2, Simon Gosling3, Maneesh Bhojak4
1Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
Background:
Progressive multifocal leukoencephalopathy (PML) has not been reported in pediatric neuromyelitis optica spectrum disorder (NMOSD) and rarely described in children.
Objectives:
To report a case of PML in childhood-onset NMOSD.
Methods:
A single retrospective case report.
Results:
Nine years after diagnosis of aquaporin-4 antibody positive NMOSD, a 17-year-old boy treated with rituximab presented with painless right visual loss over 6 weeks coinciding with CD19 repopulation. Acute relapse treatment was given but he continued to deteriorate, and JC virus was detected in cerebrospinal fluid confirming PML.
Conclusion:
PML can occur in childhood-onset NMOSD and protracted clinical presentations with unusual radiological features should prompt JCV testing. Balancing effective immunosuppression while mitigating the risks of associated complications in long-term relapsing conditions remains a challenge.
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