Application of “Mentzer’s PML case definition” to natalizumab-treated patients in the setting of strict MRI-based pharmacovigilance

ConclusionsBoth the AAN PML diagnostic criteria and the “Mentzers case definition” require the positive detection of JC virus DNA in CSF to define patients at a higher degree of suspicion of PML. However, as sensitivity of JC virus PCR in CSF is limited and often returns negative in particular in early cases of PML with a mere MRI-based PML suspicion , both criteria have obvious limitations when frequent MRI is used for pharmacovigilance purposes. Thus, revision of PML diagnostic criteria is needed, including the incorporation of lesion evolution, and longitudinal CSF studies that also assess for the presences of intrathecally produced anti-JC v irus antibodies.
Source: Journal of Neurology - Category: Neurology Source Type: research