Frontiers in Immunology (Oct 2024)

Elevation of serum neurofilament light-chain levels disclose possible occult progressive multifocal leukoencephalopathy and immune reconstitution syndrome in a patient receiving ozanimod: a case report

  • Carlos Quintanilla-Bordás,
  • David Gorriz,
  • Laura Cubas-Núñez,
  • Jéssica Castillo-Villalba,
  • Joan Carreres-Polo,
  • Bonaventura Casanova,
  • Francisco Carlos Pérez-Miralles

DOI
https://doi.org/10.3389/fimmu.2024.1465678
Journal volume & issue
Vol. 15

Abstract

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BackgroundWe report the first case of findings suggestive of progressive multifocal leukoencephalopathy and immune restitution syndrome (PML-IRIS) in a patient with multiple sclerosis receiving ozanimod preceded by an unexpected increase in the serum neurofilament light-chain (sNfL) levels.Case reportA 57-year-old-woman treated with ozanimod for the last 8 years presented, during surveillance MRI, with findings compatible with PML-IRIS. Overt clinical symptoms were absent. sNfL levels increased 4 months earlier and peaked at presentation. Lymphocyte count reached nadir of 330/mL at 8 months earlier.ConclusionThe case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors.

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