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Editorial
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Volume 353:414-416 July 28, 2005 Number 4
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Progressive Multifocal Leukoencephalopathy and Natalizumab — Unforeseen Consequences
Joseph R. Berger, M.D., and Igor J. Koralnik, M.D.

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In this issue of the Journal, there are reports describing in detail three patients in whom progressive multifocal leukoencephalopathy (PML) developed during treatment with natalizumab, a humanized monoclonal antibody against {alpha}4 integrins.1,2,3 These patients were among 3000 who had participated in clinical trials of natalizumab for the treatment of multiple sclerosis or Crohn's disease. PML is a deadly opportunistic infection of the central nervous system (CNS) for which there is no specific treatment. It is caused by reactivation of a clinically latent JC polyomavirus infection. This virus infects and destroys oligodendrocytes, leading to multifocal areas of demyelination and associated neurologic dysfunction. . . . [Full Text of this Article]


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