Universität zu Köln

Moehn, Nora, Luo, Yi, Skripuletz, Thomas, Schwenkenbecher, Philipp, Ladwig, Anne, Warnke, Clemens, Meuth, Sven G., Wiendl, Heinz, Gross, Catharina C., Schroder, Christoph, Haghikia, Aiden and Stangel, Martin (2020). Cerebrospinal fluid analysis in 108 patients with progressive multifocal leukoencephalopathy. Fluids Barriers CNS, 17 (1). LONDON: BMC. ISSN 2045-8118

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Abstract

Background Progressive multifocal leukoencephalopathy (PML) is caused by an opportunistic infection with JC polyoma virus (JCPyV) and mainly affects immunocompromised patients. It leads to pronounced demyelination of the central nervous system (CNS) resulting in severe disability or even death. Detection of JCPyV DNA in the cerebrospinal fluid (CSF) is usually accepted as proof for the diagnosis of PML. Routine CSF parameters, like CSF cell count, protein concentration, Qalbumin, or intrathecal immunoglobulin synthesis are mostly considered normal. However, this has not been investigated systematically. Methods We analyzed routine CSF parameters in a cohort of 108 PML patients that were treated at four different neurological centers in Germany. The patients exhibited different underlying conditions with natalizumab-treated multiple sclerosis (n = 54) and human immunodeficiency virus (HIV)-infection (n = 25) being the most frequent. The data were collected at the respective centers in accordance with local requirements and then jointly analyzed. The total PML cohort was compared with a control group of patients with normal pressure hydrocephalus (NPH) and idiopathic intracranial hypertension (IIH). Multiple sclerosis and HIV patients were additionally compared with their own non-PML control groups. Results The PML group showed an elevated cell count (p < 0.001) compared to the control group, however, this effect was mainly driven by HIV-PML patients. This subgroup also demonstrated a significantly higher proportion of patients with a disturbed blood-CSF-barrier function. Conclusions This comprehensive, retrospective study on CSF diagnostic analysis in PML patients provides insight into the CSF of those patients. It demonstrates that CSF composition in PML patients may be specific for the underlying condition that predisposes for the development of PML and thus data have to be interpreted in this context.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moehn, Nora UNSPECIFIED UNSPECIFIED UNSPECIFIED Luo, Yi UNSPECIFIED UNSPECIFIED UNSPECIFIED Skripuletz, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwenkenbecher, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnke, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED Meuth, Sven G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiendl, Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Gross, Catharina C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroder, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Haghikia, Aiden UNSPECIFIED UNSPECIFIED UNSPECIFIED Stangel, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-314255
DOI:	10.1186/s12987-020-00227-y
Journal or Publication Title:	Fluids Barriers CNS
Volume:	17
Number:	1
Date:	2020
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2045-8118
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MULTIPLE-SCLEROSIS; DIAGNOSIS; DISEASE; RISKS Multiple languages Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31425