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Case report
Progressive multifocal leucoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by polyomavirus JC. It results from lytic infection of glial cells and is often fatal.1 ,2 A common risk factor for PML is immunosuppression due to HIV infection or malignancy (or its treatment). PML has also been reported in those using immunomodulation therapies.3 A previous study estimated incidence of PML at 0.2/100 000 among patients with autoimmune diseases who did not have HIV or malignancy. Based on the single case of PML exposed to a biological agent, another study reported the incidence rate (IR) of PML was 2.3 (95% CI 0.1 to 71) per 100 000 person-years in patients who were exposed to biological agents and 0.8 (95% CI 0.2 to 2.5) per 100 000 person-years in those not exposed to biological agents.4
Cases of PML associated …
Footnotes
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Contributors MR and JWB provided the study concept and drafting of the manuscript. JWB and JRC supervised the study and critically revised the manuscript for important intellectual content.
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Competing interests JWB: He is a consultant for Merck, Pfizer and Astellas. Pending research grant from Bristol-Myers Squibb (BMS). JRC: He receives salary support from National Institutes of Health (AR053351) and Agency for Healthcare Research and Quality (AHRQ) (R01 R01HS018517). He is a consultant and has received research support from Amgen, Janssen, Consortium of Rheumatology Researchers of North America (CORRONA), Pfizer, Roche/Genentech, Abbvie and UCB.
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Provenance and peer review Not commissioned; externally peer reviewed.