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Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin-2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome.
Eur J Neurol. 2020 Jul 09 [Online ahead of print]EJ

Abstract

A 71-year-old Caucasian man presented with dysarthria and fluctuating hypesthesia of the right upper limb in early 2019. Brain MRI demonstrated T2/FLAIR hyperintense lesions in the left parietal cortical grey matter and adjacent white matter compatible with embolic stroke of undetermined source. Eight weeks later symptoms had further progressed with loss of adequate communication, disturbance of fine motor skills, ataxia and neuropsychiatric symptoms. Widespread disease on brain MRI and the detection of JC polyomavirus (JCPyV) DNA from cerebrospinal fluid (CSF) confirmed the diagnosis of progressive multifocal leukoencephalopathy (PML). Bone marrow biopsy revealed normal findings, and no underlying cause of reduced immunocompetence was identified. Despite rehabilitation, treatment with mirtazapine, and two cycles of interleukin-2 (IL-2, 7 x 2 mio IE s.c.) administered two weeks apart, symptoms and MRI lesions further progressed, with complete immobility and severe dysphagia.

Authors+Show Affiliations

Department of Neurology, Medical Faculty, University Hospital of Köln, Köln, Germany.Department of Neurology, Medical Faculty, University Hospital of Köln, Köln, Germany.Georgetown University Medical School, Washington, DC, USA.Institute for Virology, Medical Faculty, University Hospital of Köln, Köln, Germany.Department of Haematology, Medical Faculty, University Hospital of Köln, Köln, Germany.Department of Haematology, University Hospital Essen, Essen, Germany.Institute for Virology, Medical Faculty, University Hospital of Düsseldorf, Düsseldorf, Germany.Department of Neurology, Zürich, Switzerland.Department of Radiology, Medical Faculty, University Hospital of Köln, Köln, Germany.Department of Neurology, Medical Faculty, University Hospital of Köln, Köln, Germany.Department of Neurology, Medical Faculty, University Hospital of Köln, Köln, Germany. Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.Department of Neurology, Medical Faculty, University Hospital of Köln, Köln, Germany.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32644211

Citation

Goereci, Yasemin, et al. "Clearance of JC Polyomavirus From Cerebrospinal Fluid Following Treatment With Interleukin-2 and Pembrolizumab in an Individual With Progressive Multifocal Leukoencephalopathy and No Underlying Immune Deficiency Syndrome." European Journal of Neurology, 2020.
Goereci Y, Schweitzer F, Wellstein A, et al. Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin-2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome. Eur J Neurol. 2020.
Goereci, Y., Schweitzer, F., Wellstein, A., Silling, S., Borchmann, S., von Tresckow, B., Adams, O., Martin, R., Schlamann, M., Schroeter, M., Fink, G. R., Wattjes, M. P., & Warnke, C. (2020). Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin-2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome. European Journal of Neurology. https://doi.org/10.1111/ene.14435
Goereci Y, et al. Clearance of JC Polyomavirus From Cerebrospinal Fluid Following Treatment With Interleukin-2 and Pembrolizumab in an Individual With Progressive Multifocal Leukoencephalopathy and No Underlying Immune Deficiency Syndrome. Eur J Neurol. 2020 Jul 9; PubMed PMID: 32644211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clearance of JC polyomavirus from cerebrospinal fluid following treatment with interleukin-2 and pembrolizumab in an individual with progressive multifocal leukoencephalopathy and no underlying immune deficiency syndrome. AU - Goereci,Yasemin, AU - Schweitzer,Finja, AU - Wellstein,Anton, AU - Silling,Steffi, AU - Borchmann,Sven, AU - von Tresckow,Bastian, AU - Adams,Ortwin, AU - Martin,Roland, AU - Schlamann,Mark, AU - Schroeter,Michael, AU - Fink,Gereon R, AU - Wattjes,Mike P, AU - Warnke,Clemens, Y1 - 2020/07/09/ PY - 2020/7/10/entrez KW - JC polyomavirus KW - checkpoint inhibitor KW - pembrolizumab KW - progressive multifocal leukoencephalopathy JF - European journal of neurology JO - Eur. J. Neurol. N2 - A 71-year-old Caucasian man presented with dysarthria and fluctuating hypesthesia of the right upper limb in early 2019. Brain MRI demonstrated T2/FLAIR hyperintense lesions in the left parietal cortical grey matter and adjacent white matter compatible with embolic stroke of undetermined source. Eight weeks later symptoms had further progressed with loss of adequate communication, disturbance of fine motor skills, ataxia and neuropsychiatric symptoms. Widespread disease on brain MRI and the detection of JC polyomavirus (JCPyV) DNA from cerebrospinal fluid (CSF) confirmed the diagnosis of progressive multifocal leukoencephalopathy (PML). Bone marrow biopsy revealed normal findings, and no underlying cause of reduced immunocompetence was identified. Despite rehabilitation, treatment with mirtazapine, and two cycles of interleukin-2 (IL-2, 7 x 2 mio IE s.c.) administered two weeks apart, symptoms and MRI lesions further progressed, with complete immobility and severe dysphagia. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/32644211/Clearance_of_JC_polyomavirus_from_cerebrospinal_fluid_following_treatment_with_interleukin-2_and_pembrolizumab_in_an_individual_with_progressive_multifocal_leukoencephalopathy_and_no_underlying_immune_deficiency_syndrome L2 - https://doi.org/10.1111/ene.14435 DB - PRIME DP - Unbound Medicine ER -
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