Joseph R. Berger
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View article: Progressive multifocal leukoencephalopathy in a young adult with DOCK8 deficiency: a case of JC virus reactivation in primary immunodeficiency
Progressive multifocal leukoencephalopathy in a young adult with DOCK8 deficiency: a case of JC virus reactivation in primary immunodeficiency Open
Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal demyelinating disease of the central nervous system (CNS) caused by JC virus (JCV) reactivation in the setting of impaired cellular immunity. While commonly associated…
View article: A Multi‐Center Retrospective Cohort Study of Neurosarcoidosis Myelitis: Current Observations and Future Directions
A Multi‐Center Retrospective Cohort Study of Neurosarcoidosis Myelitis: Current Observations and Future Directions Open
Objective The optimal treatment for neurosarcoidosis myelitis is uncertain. We characterize incident neurosarcoidosis myelitis and assess treatment response by MRI and clinical scales. Methods Incident probable or definite neurosarcoidosis…
View article: Natalizumab-associated progressive multifocal leukoencephalopathy
Natalizumab-associated progressive multifocal leukoencephalopathy Open
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the brain resulting from infection of oligodendrocytes by JC virus (JCV) typically occurring in association with defects of cell-mediated immunity. The clinical…
View article: A Proposed Approach to Screening and Surveillance Labs for Patients With Multiple Sclerosis on Anti-CD20 Therapy
A Proposed Approach to Screening and Surveillance Labs for Patients With Multiple Sclerosis on Anti-CD20 Therapy Open
We propose evidence-based screening and safety surveillance labs which take into account likelihood of changing management in an otherwise stable or asymptomatic individual.
View article: Severe Neuroinvasive West Nile Virus in Association With Anti-CD20 Monotherapy for Multiple Sclerosis
Severe Neuroinvasive West Nile Virus in Association With Anti-CD20 Monotherapy for Multiple Sclerosis Open
Neuroinvasive WNV infection can develop with anti-CD20 monotherapy in the absence of additional immunosuppression. WNV serologies may be negative in the setting of anti-CD20 treatment; in the appropriate clinical context, one should consid…
View article: Commentary: Progressive multifocal leukoencephalopathy genetic risk variants for pharmacovigilance of immunosuppressant therapies
Commentary: Progressive multifocal leukoencephalopathy genetic risk variants for pharmacovigilance of immunosuppressant therapies Open
GENERAL COMMENTARY article Front. Neurol., 16 March 2023Sec. Multiple Sclerosis and Neuroimmunology Volume 14 - 2023 | https://doi.org/10.3389/fneur.2023.1146027
View article: Spinal Cord Sarcoidosis Occurring at Sites of Spondylotic Stenosis, Mimicking Spondylotic Myelopathy: A Case Series and Review of the Literature
Spinal Cord Sarcoidosis Occurring at Sites of Spondylotic Stenosis, Mimicking Spondylotic Myelopathy: A Case Series and Review of the Literature Open
Sarcoidosis is a multisystem granulomatous disease, with intramedullary spinal cord involvement seen in <1% of cases. This case series illustrates the clinical presentations and imaging findings of 5 patients with intramedullary spinal neu…
View article: Cryptococcal Meningitis Reported With Fingolimod Treatment
Cryptococcal Meningitis Reported With Fingolimod Treatment Open
The causal relationship between fingolimod treatment and CM is not yet fully understood. The CM mortality rate in fingolimod-treated patients is similar to that reported in HIV-negative patients. Vigilance for signs and symptoms of CM in p…
View article: COVID-19 Infection in Fingolimod- or Siponimod-Treated Patients
COVID-19 Infection in Fingolimod- or Siponimod-Treated Patients Open
Based on a review of available information, the risk of more severe COVID-19 in patients receiving fingolimod or siponimod seems to be similar to that reported in the general population and the MS population with COVID-19. However, limitat…
View article: Learning More About HHV-6 Encephalitis
Learning More About HHV-6 Encephalitis Open
In this issue of Neurology® Neuroimmunology & Neuroinflammation , a retrospective study using an institutional virology database addresses the clinical nature, radiologic findings, and biological underpinnings of human herpesvirus 6 (HHV-6…
View article: Improving risk‐stratification of natalizumab‐associated PML
Improving risk‐stratification of natalizumab‐associated PML Open
Based on publicly available data, we reevaluated current algorithms for stratifying the risk of progressive multifocal leukoencephalopathy (PML) in natalizumab‐treated patients with multiple sclerosis, and found that there are a number of …
View article: Aggressive multiple sclerosis (2): Treatment
Aggressive multiple sclerosis (2): Treatment Open
The natural history of multiple sclerosis (MS) is highly heterogeneous. A subgroup of patients has what might be termed aggressive MS. These patients may have frequent, severe relapses with incomplete recovery and are at risk of developing…
View article: Aggressive multiple sclerosis (1): Towards a definition of the phenotype
Aggressive multiple sclerosis (1): Towards a definition of the phenotype Open
While the major phenotypes of multiple sclerosis (MS) and relapsing–remitting, primary and secondary progressive MS have been well characterized, a subgroup of patients with an active, aggressive disease course and rapid disability accumul…
View article: COVID-19 and MS disease-modifying therapies
COVID-19 and MS disease-modifying therapies Open
Although there is currently insufficient real-world experience to definitively answer the question of the effect of a specific MS DMT on COVID-19, registries presently in nascent form should provide these answers. This review provides an a…
View article: PD-1 inhibition: a novel approach to the treatment of progressive multifocal leukoencephalopathy
PD-1 inhibition: a novel approach to the treatment of progressive multifocal leukoencephalopathy Open
Progressive multifocal leukoencephalopathy (PML), a demyelinating disease of the brain due to an ubiquitous polyoma virus, JC virus, was first recognized in 1958 (1). PML was initially described in individuals with B cell malignancies, chr…
View article: Progressive multifocal leukoencephalopathy after fingolimod treatment
Progressive multifocal leukoencephalopathy after fingolimod treatment Open
The risk of PML with fingolimod in the absence of prior natalizumab treatment is low. The estimated risk was 0.069 per 1,000 patients (95% confidence interval: 0.039-0.114), and the estimated incidence rate was 3.12 per 100,000 patient-yea…
View article: Correction to: Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event
Correction to: Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event Open
The article "Progressive multifocal leukoencephalopathy in rituximab-treated rheumatic diseases: a rare event," written by Joseph R. Berger, Vineeta Malik, Stuart Lacey, Paul Brunetta, and Patricia B. Lehane3, was originally published elec…
View article: Melanoma complicating treatment with natalizumab for multiple sclerosis: A report from the Southern Network on Adverse Reactions (SONAR)
Melanoma complicating treatment with natalizumab for multiple sclerosis: A report from the Southern Network on Adverse Reactions (SONAR) Open
A 43‐year‐old female with multiple sclerosis developed urethral melanoma. The only potential risk factor was treatment with natalizumab, a humanized monoclonal antibody against α 4 integrins. To investigate the risk‐exposure relationship, …
View article: Progressive multi‐focal leucoencephalopathy among ibrutinib‐treated persons with chronic lymphocytic leukaemia
Progressive multi‐focal leucoencephalopathy among ibrutinib‐treated persons with chronic lymphocytic leukaemia Open
Progressive multifocal leucoencephalopathy (PML) is a rare fatal infection of the central nervous system (CNS) resulting from reactivated latent John Cunningham polyoma virus (JCV). Ibrutinib, a small molecule irreversible inhibitor of Bru…
View article: CSF pleocytosis and syndrome of inappropriate antidiuretic hormone secretion in Creutzfeldt-Jakob disease
CSF pleocytosis and syndrome of inappropriate antidiuretic hormone secretion in Creutzfeldt-Jakob disease Open
A 71-year-old woman was admitted with cognitive and gait decline that progressed rapidly to the point of disability within less than a year. Her family first noticed slowing of her gait 7 months prior to admission. She subsequently began t…
View article: Diagnostic assays for polyomavirus JC and progressive multifocal leukoencephalopathy
Diagnostic assays for polyomavirus JC and progressive multifocal leukoencephalopathy Open
Summary Progressive multifocal leukoencephalopathy (PML) is a devastating and often fatal demyelinating disease of the central nervous system for which effective therapies are lacking. It is caused by the replication of polyomavirus JC (JC…
View article: Progressive Multifocal Leukoencephalopathy
Progressive Multifocal Leukoencephalopathy Open
Progressive multifocal leukoencephalopathy (PML) is a devastating demyelinating disease with significant morbidity and mortality and no effective, targeted therapies. It is most often observed in association with abnormalities of cell-medi…