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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
We 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. A 57-year-old-woma...
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| Published in: | Frontiers in immunology 2024-10, Vol.15, p.1465678 |
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| container_start_page | 1465678 |
| container_title | Frontiers in immunology |
| container_volume | 15 |
| creator | Quintanilla-Bordás, Carlos Gorriz, David Cubas-Núñez, Laura Castillo-Villalba, Jéssica Carreres-Polo, Joan Casanova, Bonaventura Pérez-Miralles, Francisco Carlos |
| description | We 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.
A 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.
The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors. |
| doi_str_mv | 10.3389/fimmu.2024.1465678 |
| format | article |
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A 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.
The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors.</description><identifier>ISSN: 1664-3224</identifier><identifier>EISSN: 1664-3224</identifier><identifier>DOI: 10.3389/fimmu.2024.1465678</identifier><identifier>PMID: 39502687</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>Biomarkers - blood ; Female ; Humans ; immune reconstitution inflammatory syndrome (IRIS) ; Immune Reconstitution Inflammatory Syndrome - blood ; Immune Reconstitution Inflammatory Syndrome - diagnosis ; Immune Reconstitution Inflammatory Syndrome - etiology ; Immunology ; Leukoencephalopathy, Progressive Multifocal - blood ; Leukoencephalopathy, Progressive Multifocal - diagnosis ; Leukoencephalopathy, Progressive Multifocal - etiology ; Magnetic Resonance Imaging ; Middle Aged ; multiple sclerosis ; Multiple Sclerosis - blood ; Multiple Sclerosis - drug therapy ; neurofilament light (NfL) chain ; Neurofilament Proteins - blood ; ozanimod (PubChem CID: 52938427) ; progressive multifocal leukoencephalopathy (PML)</subject><ispartof>Frontiers in immunology, 2024-10, Vol.15, p.1465678</ispartof><rights>Copyright © 2024 Quintanilla-Bordás, Gorriz, Cubas-Núñez, Castillo-Villalba, Carreres-Polo, Casanova and Pérez-Miralles.</rights><rights>Copyright © 2024 Quintanilla-Bordás, Gorriz, Cubas-Núñez, Castillo-Villalba, Carreres-Polo, Casanova and Pérez-Miralles 2024 Quintanilla-Bordás, Gorriz, Cubas-Núñez, Castillo-Villalba, Carreres-Polo, Casanova and Pérez-Miralles</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c350t-78f998d822df954f93f4fb9f6b14f44c40e11416a7f3da067b88ef9af1153eb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535851/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535851/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39502687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Quintanilla-Bordás, Carlos</creatorcontrib><creatorcontrib>Gorriz, David</creatorcontrib><creatorcontrib>Cubas-Núñez, Laura</creatorcontrib><creatorcontrib>Castillo-Villalba, Jéssica</creatorcontrib><creatorcontrib>Carreres-Polo, Joan</creatorcontrib><creatorcontrib>Casanova, Bonaventura</creatorcontrib><creatorcontrib>Pérez-Miralles, Francisco Carlos</creatorcontrib><title>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</title><title>Frontiers in immunology</title><addtitle>Front Immunol</addtitle><description>We 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.
A 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.
The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors.</description><subject>Biomarkers - blood</subject><subject>Female</subject><subject>Humans</subject><subject>immune reconstitution inflammatory syndrome (IRIS)</subject><subject>Immune Reconstitution Inflammatory Syndrome - blood</subject><subject>Immune Reconstitution Inflammatory Syndrome - diagnosis</subject><subject>Immune Reconstitution Inflammatory Syndrome - etiology</subject><subject>Immunology</subject><subject>Leukoencephalopathy, Progressive Multifocal - blood</subject><subject>Leukoencephalopathy, Progressive Multifocal - diagnosis</subject><subject>Leukoencephalopathy, Progressive Multifocal - etiology</subject><subject>Magnetic Resonance Imaging</subject><subject>Middle Aged</subject><subject>multiple sclerosis</subject><subject>Multiple Sclerosis - blood</subject><subject>Multiple Sclerosis - drug therapy</subject><subject>neurofilament light (NfL) chain</subject><subject>Neurofilament Proteins - blood</subject><subject>ozanimod (PubChem CID: 52938427)</subject><subject>progressive multifocal leukoencephalopathy (PML)</subject><issn>1664-3224</issn><issn>1664-3224</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVUk1v1DAQjRCIVqV_gAPykcsu8UcSmwtCVYFKlbjA2XLscdbFsYOdrLT8Q_4Vzu5Stb7Ymnnz5o3nVdVbXG8p5eKDdeO4bElN2Baztmk7_qK6xG3LNpQQ9vLJ-6K6zvmhLocJSmnzurqgoqlJy7vL6u-th72aXQwoWpQhLSMKsKRonVcjhBl5N-zmjd4pF1DBgs_IuKx9zICmmLPrPaCo9eJnNKU4JCixPaCxBJyNWvlStvyKEDRMO-XjpObdAalg0DpCAJRAx5BnNy9HHfkQTIojoNJQoYJ2q4wCArd3YUDxjwpujOZjyWqV1_oppvlN9coqn-H6fF9VP7_c_rj5trn__vXu5vP9RtOmnjcdt0JwwwkxVjTMCmqZ7YVte8wsY5rVgDHDreosNapuu55zsEJZjBsKPadX1d2J10T1IKfkRpUOMionj4GYBqnS7LQHaQ10pheGs7b8veI97wi1mOhaCd4SVbg-nbimpR_B6DJoUv4Z6fNMcDs5xL1cxTS8wYXh_Zkhxd8L5FmOZTngvQoQlywpJqwVhHR1gZITVKeytgT2sQ-u5eopefSUXD0lz54qRe-eKnws-e8g-g-EytEu</recordid><startdate>20241022</startdate><enddate>20241022</enddate><creator>Quintanilla-Bordás, Carlos</creator><creator>Gorriz, David</creator><creator>Cubas-Núñez, Laura</creator><creator>Castillo-Villalba, Jéssica</creator><creator>Carreres-Polo, Joan</creator><creator>Casanova, Bonaventura</creator><creator>Pérez-Miralles, Francisco Carlos</creator><general>Frontiers Media S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20241022</creationdate><title>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</title><author>Quintanilla-Bordás, Carlos ; Gorriz, David ; Cubas-Núñez, Laura ; Castillo-Villalba, Jéssica ; Carreres-Polo, Joan ; Casanova, Bonaventura ; Pérez-Miralles, Francisco Carlos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c350t-78f998d822df954f93f4fb9f6b14f44c40e11416a7f3da067b88ef9af1153eb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Biomarkers - blood</topic><topic>Female</topic><topic>Humans</topic><topic>immune reconstitution inflammatory syndrome (IRIS)</topic><topic>Immune Reconstitution Inflammatory Syndrome - blood</topic><topic>Immune Reconstitution Inflammatory Syndrome - diagnosis</topic><topic>Immune Reconstitution Inflammatory Syndrome - etiology</topic><topic>Immunology</topic><topic>Leukoencephalopathy, Progressive Multifocal - blood</topic><topic>Leukoencephalopathy, Progressive Multifocal - diagnosis</topic><topic>Leukoencephalopathy, Progressive Multifocal - etiology</topic><topic>Magnetic Resonance Imaging</topic><topic>Middle Aged</topic><topic>multiple sclerosis</topic><topic>Multiple Sclerosis - blood</topic><topic>Multiple Sclerosis - drug therapy</topic><topic>neurofilament light (NfL) chain</topic><topic>Neurofilament Proteins - blood</topic><topic>ozanimod (PubChem CID: 52938427)</topic><topic>progressive multifocal leukoencephalopathy (PML)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Quintanilla-Bordás, Carlos</creatorcontrib><creatorcontrib>Gorriz, David</creatorcontrib><creatorcontrib>Cubas-Núñez, Laura</creatorcontrib><creatorcontrib>Castillo-Villalba, Jéssica</creatorcontrib><creatorcontrib>Carreres-Polo, Joan</creatorcontrib><creatorcontrib>Casanova, Bonaventura</creatorcontrib><creatorcontrib>Pérez-Miralles, Francisco Carlos</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Quintanilla-Bordás, Carlos</au><au>Gorriz, David</au><au>Cubas-Núñez, Laura</au><au>Castillo-Villalba, Jéssica</au><au>Carreres-Polo, Joan</au><au>Casanova, Bonaventura</au><au>Pérez-Miralles, Francisco Carlos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Frontiers in immunology</jtitle><addtitle>Front Immunol</addtitle><date>2024-10-22</date><risdate>2024</risdate><volume>15</volume><spage>1465678</spage><pages>1465678-</pages><issn>1664-3224</issn><eissn>1664-3224</eissn><abstract>We 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.
A 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.
The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>39502687</pmid><doi>10.3389/fimmu.2024.1465678</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Frontiers in immunology, 2024-10, Vol.15, p.1465678 |
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| source | PubMed Central |
| subjects | Biomarkers - blood Female Humans immune reconstitution inflammatory syndrome (IRIS) Immune Reconstitution Inflammatory Syndrome - blood Immune Reconstitution Inflammatory Syndrome - diagnosis Immune Reconstitution Inflammatory Syndrome - etiology Immunology Leukoencephalopathy, Progressive Multifocal - blood Leukoencephalopathy, Progressive Multifocal - diagnosis Leukoencephalopathy, Progressive Multifocal - etiology Magnetic Resonance Imaging Middle Aged multiple sclerosis Multiple Sclerosis - blood Multiple Sclerosis - drug therapy neurofilament light (NfL) chain Neurofilament Proteins - blood ozanimod (PubChem CID: 52938427) progressive multifocal leukoencephalopathy (PML) |
| title | 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 |
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