Etiopathogenesis and diagnostics of progressive multifocal leukoencephalopathy in patients treated with natalizumab

Česká verze

Authors: P. Štourač ¹; J. Bednářová ²; Z. Pavelek ³
Authors place of work: Neurologická klinika LF MU a FN Brno ¹; Oddělení klinické mikrobiologie, FN Brno ²; Neurologická klinika LF UK, a FN Hradec Králové ³
Published in the journal: Cesk Slov Neurol N 2021; 84/117(2): 135-138
Category: Přehledný referát
doi: https://doi.org/10.48095/cccsnn2021135

Summary

Etiologickým agens progresivní multifokální leukoencefalopatie (PML) je polyomavirus JCV (John Cunnigham virus). PML se vyskytuje u imunosuprimovaných pacientů vč. pacientů s RS léčených imunomodulačními léky. Aktivace JCV v nervovém systému a rozvoj PML je výsledkem dysregulace zahrnující genetické a imunitní buněčné mechanizmy. Z klinického pohledu je při léčbě natalizumabem přínosem vypracování léčebného algoritmu zohledňujícího míru rizika PML s ohledem na délku léčby, předchozí užívání imunosupresiv a hodnotu protilátkového indexu JCV. Současně s využitím MR lze diagnózu PML stanovit v preklinické fázi onemocnění a zlepšit prognózu onemocnění.

Keywords:

etiopathogenesis – progressive multifocal leukoencephalopathy – natalizumab

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