PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation

<table class="table-group" id="tab1"><tr><td><table class="table"><tr><td class="thead-hr" colspan="2"><hr/></td></tr><tr><td align="left">06-06-2013</td><td align="center">3.2</td></tr><tr><td align="left">17-08-2013</td><td align="center">1.4</td></tr><tr><td align="left">17-09-2013</td><td align="center">0.9</td></tr><tr><td align="left">24-09-2013</td><td align="center">0.8</td></tr><tr><td align="left">01-10-2013</td><td align="center">0.8</td></tr><tr><td align="left">04-10-2013</td><td align="center">0.6</td></tr><tr><td align="left">08-10-2013</td><td align="center">2.8</td></tr><tr class="table-tr"><td colspan="2"><hr class="tbody-hr"/></td></tr></table></td></tr><tr class="table-fn"><td>Lymphocyte counts 2 × 10<sup>9</sup>/L (normal range 0.6–2.9). The final Fingolimod dose was administered on 11 September 2013. Increase in lymphocyte counts long after IRIS phase started (16 September 2013), suggesting that immune reconstitution occurs even in low lymphocyte state under Fingolimod.<br/></td></tr></table>

Lymphocyte counts before, during, and after Fingolimod treatment.

Case Reports in Neurological Medicine

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Table 1

Table 1: PML-IRIS during Fingolimod Diagnosed after Natalizumab Discontinuation 