دورية أكاديمية
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
| العنوان: | 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 |
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| المؤلفون: | Goereci, Y., Schweitzer, F., Fink, G. R., Wattjes, M. P., Warnke, C., Wellstein, A., Silling, S., Borchmann, S., Tresckow, B., Adams, O., Martin, R., Schlamann, M., Schroeter, M. |
| المصدر: | European journal of neurology 27(11), 2375 - 2377 (2020). doi:10.1111/ene.14435 |
| بيانات النشر: | Blackwell Science91133 |
| سنة النشر: | 2020 |
| المجموعة: | Forschungszentrum Jülich: JuSER (Juelich Shared Electronic Resources) |
| مصطلحات موضوعية: | info:eu-repo/classification/ddc/610 |
| جغرافية الموضوع: | DE |
| الوصف: | A 71‐year‐old Caucasian man presented with dysarthria and fluctuating hypoesthesia of the right upper limb in early 2019. Brain magnetic resonance imaging (MRI) demonstrated T2/fluid attenuated inversion recovery 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) [1]. 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) (1 mio IE/m² sc once per day for 7 days) administered 2 weeks apart [1, 2], symptoms and MRI lesions further progressed, with complete immobility and severe dysphagia. Nine weeks after definite PML diagnosis and 4 weeks after the last IL‐2 dose, a total of three cycles of monthly infusions of pembrolizumab were applied. At the initiation of the third cycle of pembrolizumab, cognitive performance and fine motor skills had temporarily improved, and the patient had regained the ability to walk a few steps with assistance. On MRI, no increase in lesion load and no signs of an immune reconstitution inflammatory syndrome were noted. JCPyV DNA, after a decline that started already following the IL‐2 therapy, was no longer detected in CSF, collectively suggesting PML remission (Fig. 1). Enzyme‐linked immunosorbent assays revealed increasing JCPyV‐specific antibody titers in blood and CSF (AIJCPyV > 1.5 [3]). A pembrolizumab effect was indicated by reduced programmed cell death protein 1 (PD‐1) expression on peripheral CD4+ and CD8+ T cells after the treatment. Also, during the disease course of PML and following ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/issn/1468-1331; info:eu-repo/semantics/altIdentifier/issn/1351-5101; info:eu-repo/semantics/altIdentifier/hdl/2128/25970; info:eu-repo/semantics/altIdentifier/wos/WOS:000578714700048; info:eu-repo/semantics/altIdentifier/pmid/pmid:32644211; info:eu-repo/semantics/altIdentifier/issn/1471-0552; https://juser.fz-juelich.de/record/885839Test; https://juser.fz-juelich.de/search?p=id:%22FZJ-2020-04125%22Test |
| الإتاحة: | https://doi.org/10.1111/ene.14435Test https://juser.fz-juelich.de/record/885839Test https://juser.fz-juelich.de/search?p=id:%22FZJ-2020-04125%22Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.EFC4CA4 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |