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Detection of JC virus archetype in cerebrospinal fluid in a MS patient with dimethylfumarate treatment without lymphopenia or signs of PML

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Abstract

We report a 76-year-old MS patient, treated with DMF for 3 years. Lymphocytes never showed values below 1240/µl. CSF analysis revealed 1,988,880 copies/ml of JCV-DNA, JCV-DNA was detectable in serum and anti-JCV-antibody in CSF and serum were highly positive. Stratify®-JCV-test was positive. CD8-positive T-lymphocytes were reduced. Therapy with mefloquine, mirtazapine and cidofovir resulted in complete elimination of the virus in serum and 90% reduction of viral load in CSF. This case shows that despite careful monitoring for lymphopenia JCV spreading to the CSF may occur during treatment with DMF.

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Funding

Jeremias Motte: received travel Grants from Biogen idec; Janina Kneiphof: none; Katrin Straßburger-Krogias: received travels Grants for scientific meetings from Bayer Vital; Anja Klasing: none; Ortwin Adams: received personal compensation as a speaker from Biogen Idec. Aiden Haghikia: received speaker’s honoraria from Bayer Healthcare, Biogen Idec, Merck Serono, Novartis and Teva. Ralf Gold: serves on scientific advisory boards for Teva Pharmaceutical Industries Ltd., Biogen Idec, Bayer Schering Pharma, and Novartis; has received speaker honoraria from Biogen Idec, Teva Pharmaceutical Industries Ltd., Bayer Schering Pharma, and Novartis; serves as editor for Therapeutic Advances in Neurological Diseases and on the editorial boards of Experimental Neurology and the Journal of Neuroimmunology; and receives research support from Teva Pharmaceutical Industries Ltd., Biogen Idec, Bayer Schering Pharma, Genzyme, Merck Serono, and Novartis, none related to this manuscript.

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Authors and Affiliations

  1. Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany

    Jeremias Motte, Janina Kneiphof, Katrin Straßburger-Krogias, Anja Klasing, Aiden Haghikia & Ralf Gold

  2. Institute for Virology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany

    Ortwin Adams

Authors
  1. Jeremias Motte
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  2. Janina Kneiphof
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  3. Katrin Straßburger-Krogias
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  4. Anja Klasing
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  5. Ortwin Adams
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  6. Aiden Haghikia
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  7. Ralf Gold
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Contributions

Jeremias Motte: data collection, drafting, and revising the manuscript; Janina Kneiphof: data collection, and revising the manuscript; Katrin Straßburger-Krogias: data collection, and revising the manuscript; Anja Klasing: data collection, and revising the manuscript; Ortwin Adams: data collection, and revising the manuscript; Aiden Haghikia: critical comments during data collection, drafting and manuscript revision; Ralf Gold: critical comments during data collection, drafting and manuscript revision.

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Correspondence to Ralf Gold.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving humans participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendment or comparable ethical standards.

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The patient gave consent prior to participation to the study.

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Motte, J., Kneiphof, J., Straßburger-Krogias, K. et al. Detection of JC virus archetype in cerebrospinal fluid in a MS patient with dimethylfumarate treatment without lymphopenia or signs of PML. J Neurol 265, 1880–1882 (2018). https://doi.org/10.1007/s00415-018-8931-7

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  • DOI: https://doi.org/10.1007/s00415-018-8931-7

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