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Infections 10

Topic: Imaging

Created on Monday, February 11 2013 by gliageek

Last modified on Monday, February 11 2013.


Courtesy of Dr. Mark Cohen
Patients receiving which the following therapies are at the greatest risk for this complication?

 
        A) Rituximab
 
        B) Natlazumab
 
        C) Ionizing radiation
 
        D) Solid organ transplantation
 
        E) Methotrexate
 

 


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This question was created on February 11, 2013 by gliageek.
This question was last modified on February 11, 2013.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Rituximab

This answer is incorrect.


Progressive Multifocal Leukoencephalopathy has rarely been reported in association with Rituximab therapy.  (See References)

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B) Natlazumab

This answer is correct.


The incidence of Progressive Multifocal Leukoencephalopathy in patients receiving Natalizumab for multiple sclerosis is approximately 200 per 100,000 person years. No cases have been reported in multiple sclerosis patients not receiving this therapy.  (See References)

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C) Ionizing radiation

This answer is incorrect.


Radiation therapy may be associated with a noninflammatory necrotizing leukoencephalopathy.  (See References)

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D) Solid organ transplantation

This answer is incorrect.


So far, no cases of progressive multifocal leukoencephalopathy have been reported in solid organ transplant recipients.  (See References)

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E) Methotrexate

This answer is incorrect.


Methotrexate therapy may be associated with a noninflammatory necrotizing leukoencephalopathy.  (See References)

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References:

1. Boster, A.L., Nicholas, J.A., Topalli, I., Kisanuki, Y.Y., Pei, W., Morgan-Followell, B., Kirsch, C.F., Racke, M.K., and Pitt, D. (2013). "Lessons Learned From Fatal Progressive Multifocal Leukoencephalopathy in a Patient With Multiple Sclerosis Treated With Natalizumab." JAMA Neurol 1-5. (PMID:23338729)
2. Steiner, I., and Berger, J.R. (2012). "Update on progressive multifocal leukoencephalopathy." Curr Neurol Neurosci Rep, 12(6) 680-6. (PMID:22991070)
3. Gheuens, S., Wüthrich, C., and Koralnik, I.J. (2013). "Progressive multifocal leukoencephalopathy: why gray and white matter." Annu Rev Pathol, 8 189-215. (PMID:23092189)
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imaging
Infections 10
Question ID: 021113111
Question written by gliageek. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 02/11/2013
Modified: 02/11/2013
Estimated Permutations: 120

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