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Medline ® Abstract for Reference 57

of 'Natalizumab for relapsing-remitting multiple sclerosis in adults'

Lethal multiple sclerosis relapse after natalizumab withdrawal.
Rigau V, Mania A, Béfort P, Carlander B, Jonquet O, Lassmann H, Camu W, Thouvenot E
Neurology. 2012;79(22):2214.
Natalizumab dramatically reduces relapses in patients with active multiple sclerosis (MS), but it may induce progressive multifocal leukoencephalopathy (PML).(1) A rebound of MS or an immune reconstitution inflammatory syndrome (IRIS) were described after natalizumab withdrawal, even in the absence of PML.(2,3) Very few data concerning the potential severity and the neuropathology of this event are available. We report the case of a 50-year-old patient with MS who developed a fulminating relapse 3 months after stopping natalizumab, leading to death despite intensive care and immunosuppressive therapy. Radiologic and neuropathologic findings provide interesting data regarding the nature of the rebound.
From Service d'Anatomopathologie (V.R.), Département de Réanimation Médicale (P.B., O.J.), and Département de Neurologie (B.C., W.C.), CHRU de Montpellier, UniversitéMontpellier I, Montpellier; Service de Neurologie (A.M.), CH de Béziers, Béziers, France; Center for Brain Research (H.L.), Medical University of Vienna, Vienna, Austria; and Service de Neurologie (E.T.), CHU de Nîmes, UniversitéMontpellier I, Nîmes, France.