The spectrum of progressive multifocal leukoencephalopathy: a practical approach

John Cunningham virus (JCV) infection of the central nervous system causes progressive multifocal leukoencephalopathy (PML) in patients with systemic immunosuppression. With the increased application of modern immunotherapy and biologics in various immune‐mediated disorders, the PML risk spectrum ha...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:European journal of neurology Ročník 26; číslo 4; s. 566 - e41
Hlavní autoři: Bartsch, T., Rempe, T., Leypoldt, F., Riedel, C., Jansen, O., Berg, D., Deuschl, G.
Médium: Journal Article
Jazyk:angličtina
Vydáno: England John Wiley & Sons, Inc 01.04.2019
Témata:
Biopsy
Brain
Central nervous system
Encephalitis
Immune reconstitution
Immune response
Immune system
Immunization
Immunomodulation
Immunosuppression
Immunosurveillance
Immunotherapy
Inflammation
Interleukins
JC virus
Lesions
Leukoencephalopathy
Medical imaging
Multiple sclerosis
Nervous system
Neuroimaging
Patients
Progressive multifocal leukoencephalopathy
Risk assessment
Signs and symptoms
Viral infections
Viruses
JC virus
progressive multifocal leukoencephalopathy
ISSN:1351-5101, 1468-1331, 1468-1331
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:John Cunningham virus (JCV) infection of the central nervous system causes progressive multifocal leukoencephalopathy (PML) in patients with systemic immunosuppression. With the increased application of modern immunotherapy and biologics in various immune‐mediated disorders, the PML risk spectrum has changed. Thus, new tools and strategies for risk assessment and stratification in drug‐associated PML such as the JCV antibody indices have been introduced. Imaging studies have highlighted atypical presentations of cerebral JCV disease such as granule cell neuronopathy. Imaging markers have been developed to differentiate PML from new multiple sclerosis lesions and to facilitate the early identification of pre‐clinical manifestations of PML and its immune reconstitution inflammatory syndrome. PML can be diagnosed either by brain biopsy or by clinical, radiographic and virological criteria. Experimental treatment options including immunization and modulation of interleukin‐mediated immune response are emerging. PML should be considered in any patient with compromised systemic or central nervous system immune surveillance presenting with progressive neurological symptoms.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
ObjectType-Review-3
content type line 23
ISSN:1351-5101
1468-1331
1468-1331
DOI:10.1111/ene.13906