Progressive multifocal leukoencephalopathy on dimethyl fumarate with preserved lymphocyte count but deep T-cells exhaustion.
Mult Scler
; 27(4): 640-644, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-32686582
ABSTRACT
BACKGROUND:
Progressive multifocal leukoencephalopathy (PML) among multiple sclerosis (MS) patients receiving dimethyl fumarate (DMF) is associated with iatrogenic lymphopenia, predominating on CD8+ T-cells. OBJECTIVES ANDMETHODS:
We report an unusual case of DMF-related PML in a 66-year-old MS patient with preserved lymphocyte count (nadir 810/mm3) and normal CD8+ T-cells count.RESULTS:
A massive overexpression of the inhibitory receptor Programmed Cell Death 1 (PD-1) on CD8+ and memory effector T-cells together with an impaired anti-JC virus (JCV) specific T-cells response were found, compatible with exhaustion. Following DMF withdrawal, PML progressively regressed, PD-1 was downregulated, and a functional anti-JCV response was established.CONCLUSION:
T-cells exhaustion may favor PML onset on DMF independently of lymphocyte count.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Leucoencefalopatia Multifocal Progressiva
/
Vírus JC
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Linfopenia
Limite:
Aged
/
Humans
Idioma:
En
Revista:
Mult Scler
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França