Progressive multifocal leukoencephalopathy in rheumatic diseases: Evolving clinical and pathologic patterns of disease

Calabrese, Leonard H.; Molloy, Eamonn; Huang, DeRen; Ransohoff, Richard M.

doi:10.1002/art.22657

Cited by 169 publications

(116 citation statements)

References 102 publications

(118 reference statements)

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…Calabrese et al 18 recently reviewed 37 cases of PML in the setting of rheumatic diseases. All patients in this series were treated with some form of immunosuppressant before PML manifestation.…”

Section: Pml In Rheumatologic Conditionsmentioning

confidence: 99%

JC Virus Infection of the Brain

Bag¹,

Curé²,

Chapman³

et al. 2010

AJNR Am J Neuroradiol

118

View full text Add to dashboard Cite

SUMMARY:Since its initial description, there have been significant changes in the epidemiology, pathogenesis, and clinical and imaging manifestations of JCV infection of brain. The most common clinical manifestation is PML. Other recently described CNS manifestations are JCE, JCVGCN, and JCM. Although AIDS is the most common predisposing factor for JCV reactivation, there is increasing incidence of brain manifestations of JCV reactivation in non-HIV settings, including different rheumatologic, hematologic, and oncologic conditions; monoclonal antibody therapy; transplant recipients; primary immunodeficiency syndromes; and even in patients without any recognizable immune deficiency. IRIS may develop secondary to restoration of immunity in HIV-positive patients with PML receiving antiretroviral therapy. This is of profound clinical significance and needs to be diagnosed promptly. Imaging plays a crucial role in the diagnosis of the disease, monitoring of treatment response, identifying disease progression, and predicting prognosis. In this article, current understanding of the epidemiology, pathogenesis, clinical presentations, and all aspects of imaging of JCV infection of the brain have been comprehensively reviewed.ABBREVIATIONS: ADC ϭ apparent diffusion coefficient; CNS ϭ central nervous system; cPML ϭ classic PML; Cr ϭ creatine; CTL ϭ cytotoxic T-lymphocytes; DWI ϭ diffusion-weighted imaging; FLAIR ϭ fluid-attenuated inversion recovery; HAART ϭ highly active antiretroviral therapy; HIV ϭ human immunodeficiency virus; ICL ϭ idiopathic CD4 lymphocytopenia; iPML ϭ inflammatory PML; IRIS ϭ immune reconstitution inflammatory syndrome; JCE ϭ JCV encephalopathy; JCM ϭ JCV meningitis; JCV ϭ JC virus; JCVGCN ϭ JCV granular cell neuronopathy; mAb ϭ monoclonal antibody; mIns ϭ myo-inositol; MS ϭ multiple sclerosis; MTR ϭ magnetization transfer ratio; NAA ϭ N-acetylaspartate; NIRIS ϭ neuro-IRIS; PCR ϭ polymerase chain reaction; PML ϭ progressive multifocal leukoencephalopathy; PML-IRIS ϭ PML associated with IRIS; RR ϭregulatory region; SLE ϭ systemic lupus erythematosus

show abstract

Section: Pml In Rheumatologic Conditionsmentioning

confidence: 99%

JC Virus Infection of the Brain

Bag¹,

Curé²,

Chapman³

et al. 2010

AJNR Am J Neuroradiol

118

View full text Add to dashboard Cite

show abstract

“…The incidence of JCV reactivation and PML in patients with autoimmune diseases is currently unknown, although a recent review identified 35 cases of PML occurring in patients with rheumatic diseases, all of whom had been treated with nonbiologic therapies (65). Since nearly two-thirds of the cases were in conjunction with SLE as an underlying diagnosis, this condition may be a risk factor for developing PML.…”

Section: Polyomavirusmentioning

confidence: 99%

“…Two cases of PML were reported recently in patients who had received rituximab as off-label treatment for SLE (75). Given that both patients had previously undergone intensive immunosuppression and that SLE itself could predispose individuals to PML (65), it is difficult to assess the risk of PML that may be associated with rituximab therapy.…”

Section: Polyomavirusmentioning

confidence: 99%

Viral infection and reactivation in autoimmune disease

Chakravarty

2008

Arthritis & Rheumatism

View full text Add to dashboard Cite

“…Although there were no participants with PML included in our review, PML has attracted the attention of rheumatologists for reports about its association with the use of rituximab (Calabrese et al, 2007). In December 2006, the US Food and Drug Administration (FDA) issued an alert about the death of two PML cases with SLE, both of whom had been treated with rituximab (Molloy and Calabrese, 2010).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of rituximab therapy for systemic lupus erythematosus: a systematic review and meta-analysis

Lan

Han

Chen

2012

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

Abstract:Objective: To review the efficacy and safety of rituximab therapy for systemic lupus erythematosus (SLE). Methods: We searched for randomized controlled trails and observational studies that evaluated the effect of rituximab based on the systemic lupus erythematosus disease activity index (SLEDAI), British Isles lupus assessment group index (BILAG), urine protein levels, and the prednisolone dose, and had adequate data to calculate the mean, standard deviation (SD), and 95% confidence intervals, and to systematically review and meta-analyze observational studies with fixed effects model or random effects model. Results: We included 2 randomized controlled studies and 19 observational clinical studies. We summarized the data from the 19 observational studies, analyzed the heterogeneity of the literature, and then used fixed effect model or random effect model for statistical analysis. The SLEDAI, BILAG, and urine protein levels and the prednisolone dosage were decreased after rituximab treatment, and the decreases in the BILAG, urine protein levels, and the prednisolone dose were found to be significant (P<0.05), when compared with baseline level. Rituximab's adverse effects generally could be controlled with an effective dosing regimen. Conclusions: Although there are still controversies about rituximab's treatment on SLE, but our study had showed that rituximab had favorable effects on refractory lupus. The long-term efficacy and safety of rituximab require further study.

show abstract

Progressive multifocal leukoencephalopathy in rheumatic diseases: Evolving clinical and pathologic patterns of disease

Cited by 169 publications

References 102 publications

JC Virus Infection of the Brain

JC Virus Infection of the Brain

Viral infection and reactivation in autoimmune disease

Efficacy and safety of rituximab therapy for systemic lupus erythematosus: a systematic review and meta-analysis

Contact Info

Product

Resources

About