Natalizumab-associated reversible encephalopathy syndrome mimicking progressive multifocal leukoencephalopathy

Mult Scler. 2013 Feb;19(2):249-51. doi: 10.1177/1352458512448268. Epub 2012 May 17.

Abstract

Progressive multifocal leukoencephalopathy is a rare but potentially lethal adverse event in natalizumab treated multiple sclerosis patients. We report on a 40-year old Caucasian man with typical relapsing progressive multiple sclerosis, who developed a reversible leukoencephalopathy syndrome after 43 natalizumab infusions mimicking progressive multifocal leukoencephalopathy. To our knowledge, this is the first case of its kind. Our case suggests that awareness ought to be sharpened for reversible leukoencephalopathy syndrome in the follow-up of natalizumab treated multiple sclerosis patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Anticonvulsants / therapeutic use
  • Brain / pathology
  • Brain Diseases / chemically induced*
  • Brain Diseases / diagnosis*
  • Glatiramer Acetate
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Leukoencephalopathy, Progressive Multifocal / chemically induced*
  • Leukoencephalopathy, Progressive Multifocal / diagnosis*
  • Magnetic Resonance Imaging
  • Male
  • Multiple Sclerosis, Chronic Progressive / complications*
  • Multiple Sclerosis, Chronic Progressive / drug therapy
  • Natalizumab
  • Peptides / therapeutic use
  • Psychomotor Agitation / complications
  • Seizures / chemically induced
  • Seizures / drug therapy
  • Spinal Cord / pathology

Substances

  • Antibodies, Monoclonal, Humanized
  • Anticonvulsants
  • Immunosuppressive Agents
  • Natalizumab
  • Peptides
  • Glatiramer Acetate