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Previous Volume 353:369-374 July 28, 2005 Number 4 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Berger, J. R. Editorial by Drazen, J. M. Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

A 46-year-old woman with relapsing–remitting multiple sclerosis died from progressive multifocal leukoencephalopathy (PML) after having received 37 doses of natalizumab (300 mg every four weeks) as part of a clinical trial of natalizumab and interferon beta-1a. PML was diagnosed on the basis of the finding of JC viral DNA in cerebrospinal fluid on polymerase-chain-reaction assay and was confirmed at autopsy. Nearly every tissue section from bilateral cerebral hemispheres contained either macroscopic or microscopic PML lesions. There was extensive tissue destruction and cavitation in the left frontoparietal area, large numbers of bizarre astrocytes, and inclusion-bearing oligodendrocytes, which were positive for JC virus DNA on in situ hybridization.

Source Information

From the Departments of Pathology (B.K.K.-D.), Neurology (B.K.K.-D., K.L.T.), Neurosurgery (B.K.K.-D.), Medicine (K.L.T.), Microbiology (K.L.T.), and Immunology (K.L.T.), University of Colorado Health Sciences Center; and the Denver Veterans Affairs Medical Center (K.L.T.) — both in Denver.

This article was published at www.nejm.org on June 9, 2005.

Address reprint requests to Dr. Kleinschmidt-DeMasters at the Department of Pathology, B-216, University of Colorado Health Sciences Center, 4200 E. 9th Ave., Denver, CO 80262.

Full Text of this Article

Related Letters:

Progressive Multifocal Leukoencephalopathy, Natalizumab, and Multiple Sclerosis
Berger T., Deisenhammer F., Álvarez-Cermeño J. C., Masjuan J., Villar L. M., Kleinschmidt-DeMasters B.K., Tyler K. L., Langer-Gould A., Atlas S. W., Pelletier D.
Extract | Full Text | PDF  
N Engl J Med 2005; 353:1744-1746, Oct 20, 2005. Correspondence

Natalizumab and Progressive Multifocal Leukoencephalopathy
Adelman B., Sandrock A., Panzara M. A.
Extract | Full Text | PDF  
N Engl J Med 2005; 353:432-433, Jul 28, 2005; published at www.nejm.org on Jun 9, 2005 (10.1056/NEJMc055235). Correspondence

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