Cerebral abscess in a multiple sclerosis patient during treatment with natalizumab
Natalizumab is a monoclonal antibody against α4-integrin and inhibits lymphocyte transmigration across the blood brain barrier . This treatment is highly efficacious in relapsing–remitting multiple sclerosis (RRMS) but associated with a higher risk of developing central nervous system (CNS) infections . We describe a case of a long-term natalizumab-treated RRMS patient who developed a cerebral abscess.
KeywordsNatalizumab Abscess Bacterial infection Multiple sclerosis Immune system
BD drafted the original manuscript. AV, GdlM, CJ and BW provided critical revision of the manuscript for intellectual content. JvG provided additionally radiographic figures. All the authors gave final approval of the version to be published.
Compliance with ethical standards
Conflict of interest
Busra Durmus, Johan van Goethem, Alex Vercruyssen and Chris Jadoul reported no disclosures. Barbara Willekens: the institution (Antwerp University Hospital) received fees for speaking, consultancy and grants from Biogen, Sanofi-Genzyme, Roche, Novartis and Merck Serono. All fees are used for research purposes. BW received travel support from Biogen, Teva, Sanofi, Roche, Novartis and Merck Serono. Gino de la Meilleure: He received fees for speaking, consultancy, travel support and research from Biogen, Sanofi-Genzyme, Roche, Novartis, Merckx and Teva.
- 1.Tramacere I, Del Giovane C, Salanti G, D’Amico R, Filippini G (2015) Immunomodulators and immunosuppressants for relapsing–remitting multiple sclerosis: a network meta-analysis. Cochrane Database Syst Rev 18:CD011381Google Scholar
- 2.Planas R, Martin R, Sospedra M (2014) Long-term safety and efficacy of natalizumab in relapsing–remitting multiple sclerosis: impact on quality of life. Patient Relat Outcome Meas 4:25–33Google Scholar
- 4.Iannetta M, Zingaropoli MA, Bellizzi A, Morreale M, Pontecorvo S, D’Abramo A, Oliva A, Anzivino E, Lo Menzo S, D’Agostino C, Mastroianni CM, Millefiorini E, Pietropaolo V, Francia A, Vullo V, Ciardi MR (2016) Natalizumab affects T-cell phenotype in multiple sclerosis: implications for JCV reactivation. PLoS One 3 11(8):e0160277CrossRefGoogle Scholar
- 6.Warnke C, Stettner M, Lehmensiek V, Dehmel T, Mausberg AK, von Geldern G, Gold R, Kümpfel T, Hohlfeld R, Mäurer M, Stangel M, Straeten V, Limmroth V, Weber T, Kleinschnitz C, Wattjes MP, Svenningsson A, Olsson T, Hartung HP, Hermsen D, Tumani H, Adams O, Kieseier BC (2015) Natalizumab exerts a suppressive effect on surrogates of B cell function in blood and CSF. Mult Scler. 21:1036–1044CrossRefGoogle Scholar
- 7.Kragha KO (2016) Multiple brain abscesses due to Streptococcus anginosus: prediction of mortality by an imaging severity index score. Case Rep Radiol 7040352:1–8Google Scholar