A case report of simultaneous PML-IRIS during corticosteroids tapering in a patient with an anti-synthetase syndrome [v1; ref status: indexed, http://f1000r.es/2l6]
Guillaume Martin-Blondel,
David Brassat,
Hervé Dumas,
Emmanuelle Uro-Coste,
Daniel Adoue,
Hans Lassmann,
Michel Clanet
Affiliations
Guillaume Martin-Blondel
Université Toulouse III, Toulouse F-31000, France
David Brassat
Department of Neurology, Toulouse University Hospital, Toulouse, France
Hervé Dumas
Department of Neuroradiology, Toulouse University Hospital, Toulouse, France
Emmanuelle Uro-Coste
Department of Pathology, Toulouse University Hospital, Toulouse, France
Daniel Adoue
Department of Internal Medicine, Toulouse University Hospital, Toulouse, France
Hans Lassmann
Center for Brain Research, Medical University of Vienna, Vienna, Austria
Michel Clanet
Department of Neurology, Toulouse University Hospital, Toulouse, France
We report a case of simultaneous progressive multifocal leukoencephalopathy-associated immune reconstitution inflammatory syndrome (PML-IRIS) during corticosteroid tapering in a patient with an anti-synthetase syndrome. We describe the challenges associated with the diagnosis and the management of this emerging inflammatory neurological condition in this immunocompromised patient with a severe rheumatic disease. We highlight that, in the setting of IRIS, the low-level of the JC virus viral load requires a sensitive PCR assay before excluding PML.
