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Jeantin L, Shor N, Coustans M, Roos-Weil D, Quintin-Roué I, Bellanger A, Le Garff-Tavernier M, Ben Jemaa R, Thabut D, Pourcher V, Weiss N. Progressive multifocal leukoencephalopathy in patients with chronic liver disease successfully treated with pembrolizumab. J Neurol 2024; 271:2119-2124. [PMID: 38143261 DOI: 10.1007/s00415-023-12163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Affiliation(s)
- Lina Jeantin
- Département de Neurologie, Sorbonne Université, Médecine Intensive Réanimation à Orientation Neurologique, AP-HP.Sorbonne Université, Hôpital Pitié-Salpêtrière, 47-83, Boulevard de L'hôpital, 75013, Paris, France
| | - Natalia Shor
- Department of Neuroradiology, Pitié-Salpétrière University Hospital, AP-HP, 47-83 bd de L'hôpital, 75013, Paris, France
| | - Marc Coustans
- Department of Neurology, CHIC Quimper-Concarneau, 14 Avenue Yves Thépot - BP 1757, 29107, Quimper, Cedex, France
| | - Damien Roos-Weil
- Sorbonne Université, Department of Clinical Hematology, Pitié-Salpétrière University Hospital, AP-HP, 47-83 bd de L'hôpital, 75013, Paris, France
| | | | - Agnès Bellanger
- Pharmacie hospitalière, Sorbonne Université, AP-HP, Hôpital Pitié Salpêtrière, 75013, Paris, France
| | - Magali Le Garff-Tavernier
- Department of Biological Hematology, Pitié-Salpétrière University Hospital, AP-HP, 47-83 bd de L'hôpital, 75013, Paris, France
| | - Rahma Ben Jemaa
- Liver Intensive Care Unit, Hepatogastroenterology Department, AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- Sorbonne Université, 75005, Paris, France
| | - Dominique Thabut
- Brain Liver Salpêtrière Study Group, Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint-Antoine & Institute of Cardiometabolism and Nutrition (ICAN), 75013, Paris, France
- Liver Intensive Care Unit, Hepatogastroenterology Department, AP-HP, Sorbonne Université, Pitié-Salpêtrière Hospital, 47-83 Boulevard de L'Hôpital, 75013, Paris, France
- Sorbonne Université, 75005, Paris, France
| | - Valérie Pourcher
- Sorbonne Université, 75005, Paris, France
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), AP-HP, Hôpital Pitié Salpêtrière, Service Des Maladies Infectieuses et Tropicales, Paris, France
| | - Nicolas Weiss
- Département de Neurologie, Sorbonne Université, Médecine Intensive Réanimation à Orientation Neurologique, AP-HP.Sorbonne Université, Hôpital Pitié-Salpêtrière, 47-83, Boulevard de L'hôpital, 75013, Paris, France.
- Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, INSERM UMR_S 938, Centre de Recherche Saint-Antoine, Maladies Métaboliques, Biliaires et Fibro-Inflammatoire du Foie, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
- Groupe de Recherche Clinique en REanimation et Soins Intensifs du Patient en Insuffisance Respiratoire aiguE (GRC-RESPIRE) Sorbonne Université, Paris, France.
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Engel S, Molina Galindo LS, Bittner S, Zipp F, Luessi F. A Case of Progressive Multifocal Leukoencephalopathy in a Fumaric Acid-Treated Psoriasis Patient With Severe Lymphopenia Among Other Risk Factors. J Cent Nerv Syst Dis 2022; 13:11795735211037798. [PMID: 34992484 PMCID: PMC8725211 DOI: 10.1177/11795735211037798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Progressive multifocal leukoencephalopathy (PML) is a potentially fatal condition caused by a brain infection with JC polyomavirus (JCV), which occurs almost exclusively in immunocompromised patients. Modern immunosuppressive and immunomodulatory treatments for cancers and autoimmune diseases have been accompanied by increasing numbers of PML cases. We report a psoriasis patient treated with fumaric acid esters (FAEs) with concomitant hypopharyngeal carcinoma and chronic alcohol abuse who developed PML. Grade 4 lymphopenia at the time point of PML diagnosis suggested an immunocompromised state. This case underscores the importance of immune cell monitoring in patients treated with FAEs, even more so in the presence of additional risk factors for an immune dysfunction.
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Affiliation(s)
- Sinah Engel
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Lara S Molina Galindo
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stefan Bittner
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Frauke Zipp
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Felix Luessi
- Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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