Background Progressive multifocal leukoencephalopathy (PML) is one of the most serious treatment-related complications that is encountered in patients with multiple sclerosis (MS). PML is a serious complication of MS treatment which is most commonly related to natalizumab. Case presentation We report clinical course of progressive multifocal leukoencephalopathy (PML) in a 40-year-old man who was on treatment for highly active relapsing-remitting multiple sclerosis with natalizumab (Nz). He was treated with steroids, cidofovir, and mirtazapine and went on to develop long-term disability. The case describes the evolution of PML from diagnosis up till 5 months with changes on sequential brain scans and clinical symptoms in our patient. Conclusion Patients who are on natalizumab should be aware and consented for the risk of PML. They should be periodically re-assessed for their relative PML risk. There is a growing body of evidence that suggests switching patients from natalizumab who have a higher risk of PML to other safer treatment options.

中文翻译：

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多发性硬化症 (MS) 中的那他珠单抗相关进行性多灶性白质脑病 (PML)：“来自爱尔兰的病例报告，包括文献回顾、临床陷阱和未来方向”

背景进行性多灶性白质脑病 (PML) 是多发性硬化症 (MS) 患者遇到的最严重的治疗相关并发症之一。PML 是 MS 治疗的严重并发症，最常与那他珠单抗有关。病例介绍 我们报告了一名 40 岁男性的进行性多灶性白质脑病 (PML) 的临床过程，他正在使用那他珠单抗 (Nz) 治疗高度活跃的复发缓解型多发性硬化症。他接受了类固醇、西多福韦和米氮平治疗，并继续发展为长期残疾。该病例描述了 PML 从诊断到 5 个月的演变过程，以及我们患者的连续脑部扫描和临床症状的变化。结论 服用那他珠单抗的患者应了解并同意 PML 的风险。应定期重新评估他们的相对 PML 风险。越来越多的证据表明，将患有 PML 风险较高的那他珠单抗患者转换为其他更安全的治疗方案。