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Incidence and risk factors for progressive multifocal leukoencephalopathy among patients with selected rheumatic diseases.
Bharat A, Xie F, Baddley JW, Beukelman T, Chen L, Calabrese L, Delzell E, Grijalva CG, Patkar NM, Saag K, Winthrop KL, Curtis JR
(2012) Arthritis Care Res (Hoboken) 64: 612-5
MeSH Terms: Aged, Aged, 80 and over, Antibodies, Monoclonal, Murine-Derived, Humans, Incidence, Leukoencephalopathy, Progressive Multifocal, Retrospective Studies, Rheumatic Diseases, Risk Factors, Rituximab, Tumor Necrosis Factor-alpha, United States
Show Abstract · Added July 27, 2018
OBJECTIVE - To ascertain the incidence of progressive multifocal leukoencephalopathy (PML) in patients with selected rheumatic diseases, to describe the characteristics of PML cases occurring in this setting, and to evaluate the extent to which such cases occurred in the context of biologic therapies such as rituximab or tumor necrosis factor antagonists.
METHODS - We conducted a large population-based study to describe the incidence and risk factors for PML among patients with rheumatoid arthritis, psoriatic arthritis, psoriasis, juvenile idiopathic arthritis, inflammatory bowel disease, and ankylosing spondylitis using national inpatient and outpatient administrative data from the entire Center for Medicare and Medicaid Services from 2000-2009. Suspected PML cases were identified using hospital discharge diagnosis codes. Risk factors for PML were evaluated using outpatient data ≥6 months prior to PML diagnosis.
RESULTS - Among 2,030,578 patients with autoimmune diseases of interest, a total of 53 PML cases were identified (2.6 per 100,000 patients). Most PML cases had human immunodeficiency virus (HIV) and/or cancer. Nine PML cases had evidence for biologic use prior to PML hospitalization, of which 3 had neither HIV nor malignancy and were exposed to biologics within 12 (rituximab) or 6 months (all other biologics) prior to PML diagnosis. PML occurred at an estimated incidence of 0.2 per 100,000 patients with autoimmune diseases who did not have HIV or malignancy.
CONCLUSION - PML occurs at a very low incidence among patients with rheumatic diseases but can occur even in the absence of HIV or malignancy.
Copyright © 2012 by the American College of Rheumatology.
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MeSH Terms
Progressive multifocal leukoencephalopathy in a patient with follicular lymphoma treated with multiple courses of rituximab.
Reddy N, Abel TW, Jagasia M, Morgan D, Weaver K, Greer J
(2009) Leuk Lymphoma 50: 460-2
MeSH Terms: Antibodies, Monoclonal, Antibodies, Monoclonal, Murine-Derived, Ataxia, Fatal Outcome, Female, Humans, Leukoencephalopathy, Progressive Multifocal, Lymphoma, Follicular, Magnetic Resonance Imaging, Middle Aged, Rituximab
Added March 5, 2014
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11 MeSH Terms
Progressive multifocal leukoencephalopathy.
Minnick A, Oleson AJ
(1982) J Neurosurg Nurs 14: 82-4
MeSH Terms: Anti-Bacterial Agents, Cytarabine, Humans, Leukoencephalopathy, Progressive Multifocal, Patient Education as Topic, Virus Diseases
Added January 20, 2015
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6 MeSH Terms