Search results for "Progressive Multifocal"

Drug‐refractory myasthenia gravis: Clinical characteristics, treatments, and outcome

2022

[Objective] To describe the clinical characteristics and outcomes in patients with refractory myasthenia gravis (MG) and to determine the effectiveness and side effects of the drugs used for their treatment.

No evidence of beneficial effects of plasmapheresis in natalizumab-associated PML

2017

Objective:To examine retrospectively the effects of plasmapheresis (PLEX) on the survival and clinical outcomes of patients with multiple sclerosis (MS) and natalizumab (NTZ)–associated progressive multifocal leukoencephalopathy (PML).Methods:The medical literature was searched for the terms natalizumab and progressive multifocal leukoencephalopathy. A total of 193 international and 34 Italian NTZ-PML cases were included. Clinical outcome was determined by comparing the patients' clinical status at PML diagnosis with status after PML resolution. The effects on survival and clinical outcome of PLEX, sex, age, country, pre-PML Expanded Disability Status Scale score, NTZ infusion number, prior…

Characteristic morphologic manifestation of CADASIL, cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy, in s…

1997

Four cases of progressive multifocal leukoencephalopathy in iatrogenic immunocompromised patients

2020

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by John Cunningham Virus (JCV). We report four PML cases in immunocompromised patients, respectively treated with (1) Natalizumab, (2) Rituximab, (3) autologous stem-cell transplantation, and (4) Tacrolimus. All patients underwent neurological examination, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), JCV-DNA research on biological samples, and lymphocytes subpopulation study. All cases presented with motor, behavioural, and cognitive disorders. Visual, sensitive, and cerebellar deficits developed in three cases. MRI revealed widespread progressiv…

Immunological Markers for PML Prediction in MS Patients Treated with Natalizumab

2015

International audience; Natalizumab (NTZ), a monoclonal antibody recognizing the alpha4 integrin chain, has been approved for the treatment of active multiple sclerosis, but expose to the onset of a rare side effect, progressive multifocal leukoencephalopathy (PML). Estimating the individual risk of PML in NTZ-treated patients is a major challenge, and therapeutic strategies are mainly guided by the overall PML risk assessed by identified risk factors: JC virus (JCV) seropositivity, treatment duration (with peak incidence after 24 months), and the previous use of immunosuppressive therapies. Given that this stratification does not yet allow a precise individual prediction of PML, other pred…

CT and MR Imaging of Non-neoplastic Intracranial Masses

1989

Many intracranial mass lesions of non-neoplastic origin present CT and MR features similar or identical to those of true neoplasms. In many cases a definitive diagnosis cannot be made from imaging findings alone, and misinterpretation is possible even when the history and clinical findings are considered. Yet an accurate preoperative diagnosis is an essential prerequisite for selecting candidates for a neurosurgical operation and planning the procedure. In some cases the full range of neuroradiologic techniques may have to be applied and evaluated in the context of clinical findings before the physician can accurately classify the disease and draw appropriate therapeutic conclusions.

Natalizumab therapy of multiple sclerosis: recommendations of the Multiple Sclerosis Study Group-Italian Neurological Society

2011

Three years after the introduction of natalizumab (NA) therapy for the second line treatment of relapsing-remitting multiple sclerosis (MS), Italian MS centers critically reviewed the scientific literature and their own clinical experience. Natalizumab was shown to be highly efficacious in the treatment of MS. However, the risk of progressive multifocal leukoencephalopathy was confirmed and defined better. This article summarizes the MS-SIN Study Group recommendations on the use of NA in MS, with particular reference to the appropriate selection and monitoring of patients as well as to the management of adverse events.

Standard Therapeutic Approach and New Therapies

2015

The traditional approach to therapy of Crohn’s disease has been the step-up approach usually represented as a pyramid (Fig. 7.1) where, progressing from mild to severe disease, therapeutic choices proceed step by step from less potent drugs at the basement of the pyramid to more potent but also more toxic drugs at the top. The advent of biological therapies and the wider use of immunomodulators, together with the opportunity to achieve ambitious treatment goals and possibly to modify the course of disease, have led to other approaches such as the accelerated step-up or the top-down approach. This means that immunomodulators and biologics can be used earlier and de-escalated when disease is …