Application of the CSF JCV antibody index to early natalizumab-associated progressive multifocal leukoencephalopathy

Introduction

Progressive multifocal leukoencephalopathy (PML) is a severe adverse event in patients with multiple sclerosis (MS) treated with natalizumab. Brain MRI can detect small PML lesions at an early disease stage.1 Therefore, MRI screening is recommended for patients at high risk of developing PML.2 Diagnosis of PML is confirmed by brain biopsy or detection of JC virus (JCV) DNA from cerebrospinal fluid (CSF).3 However, in spite of using ultrasensitive quantitative PCR (qPCR) protocols, patients with PML can be JCV DNA negative in CSF, hampering the diagnosis. Recently, we demonstrated that the detection of intrathecally produced anti-JCV IgG antibodies is highly specific for diagnosis of PML, making the so-called CSF JCV antibody index (AI_JCV) a candidate tool for earlier diagnosing of PML in a proportion of natalizumab-associated PML patients.4

The aim of this study was to assess the value of the AI_JCV...

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2AggfTU