Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies

Expression of BKV and JCV encoded microRNA in human cerebrospinal fluid, plasma and urine

“…In case of high viral copies indicative of PVAN, decreased immunosuppressive medication is recommended [12]. When PML is suspected, JCV DNA in cerebrospinal fluid is measured to help establish or exclude diagnosis, together with magnetic resonance imaging, brain histopathology, and clinical symptoms [13]. Determination of JCV antibody status to assess the risk of PML among MS patients receiving or considered to commence natalizumab therapy has been enlaunched in the management of MS patients in many countries including Finland.…”

Chronic Infectious Inflammatory Diseases of the Central Nervous System

“…In HIV-infected patients who have developed PML-immune reconstitution infl ammatory syndrome as a result of antiretroviral therapy, detection of JCV declines substantially. Repeated testing of CSF may be needed, but testing of blood or urine for JCV has no diagnostic value (Berger et al 2013 ;Mentzer et al 2012 ;Fong et al 1995 ). A novel method for mutation scanning has been developed with the potential to serve as an additional diagnostic method when combined with routine RT-PCR testing (Nakamichi et al 2014 ).…”

“…15.3 ), cerebellum or peduncles, but also grey matter involvement can occur rarely. Typical histopathological fi ndings include enlarged oligodendroglial nuclei, bizarre astrocytes and demyelination (Berger et al 2013 ;Mentzer et al 2012 ;Steiner and Berger 2012 ).…”

Immunological biomarkers identifying natalizumab-treated multiple sclerosis patients at risk of progressive multifocal leukoencephalopathy

“…The other strategies commonly used for the diagnosis of natalizumabinduced PML, such as magnetic resonance imaging (MRI) (Vennegoor et al, 2011;Ayzenberg et al, 2012), quantitative polymerase chain reaction (PCR) for detection of JCV DNA in CSF Mentzer et al, 2012;Berger et al, 2013), and JCV antibody index in CSF, which measures intrathecal synthesis of anti-JCV antibodies , at present, do not appear to be useful as biomarkers predictive of PML risk prior to therapy initiation.…”