Question 1

is it possible that or does the drug methetrexate cause progressive multifocal leukoencephalopathy (pml)?

Accepted Answer

Yes: However, that issue is incredible rare if Methotrexate is used alone and not in combination with other agents including prednisone, biologics or other immunosuppressives.

Question 2

how can we detect pml?

Accepted Answer

MRI & biopsy: The pattern on MRI of the brain can be very suggestive, but a biopsy (surgery to get brain tissue to examine) is the only way to definitively diagnose it.

Question 3

what are the tests for pml?

Accepted Answer

MRI, spinal fluid: Mri, clinical exam, pathologic tissue and spinal fluid are all tests for progressive multifocal leukoencephalopathy.  It depends on the presentation and suspicion for this terrible disease.

Question 4

is there a gentle way to treat pml?

Accepted Answer

NO: Pml is caused by the jc virus. It can lie dormant in an immunocompetent host for a lifetime. In the immunocompromised host, pml is uniformly fatal without reconstitution of the immune system. There have been several reports of antiviral agents being used to treat pml in immunocompromised states, the numbers are very limited and the treatment is not gentle. To answer your question...No.

Question 5

what are the symptoms associated with pml?

Accepted Answer

PML: Progressive multifocal leukoencephalopathy is a rapidly progressive viral infection of the brain caused by creutzfeldt jacob papova virus which affect support cells of the brain. Causes headaches, memory loss, speech & vision difficulties, changes in mental status, seizures, partial paralysis, limb weakness, incoordination, and finally coma & death.

Question 6

how do we prevent pml?

Accepted Answer

Assuming you have ms: Assuming you mean progressive multifocal leukoencephalopathy, and assuming you are on tysabri, (natalizumab) your dr. Now has the availability of serum titters to see if you are at risk.  If you are, the only means of prevention is to follow titters.

Question 7

how does pml affect people with hiv?

Accepted Answer

Poor prognosis: Pml is an infection of the brain by the jc virus, that usually only occurs if the immune system is very compromised (full blown aids, on transplant meds or some other meds).  It causes brain damage and is usually fatal within a year when it does occur in aids.

Question 8

can you please give me more information on the jc virus and pml?

Accepted Answer

Virus PML: JC virus is from a prion infection, originally discovered in head hunters in New Guinea. Infection is rare and no treatment is yet available. PML is a disease of the white matter of the brain and there are many causes for most of which are either infectious or congenital

Question 9

does the benefit of  tysabri (natalizumab) outweigh the risk of pml ?

Accepted Answer

Individualized: Tysabri/natalizumab is an immunosuppressant used in the treatment of relapsing forms of MS. PML (progressive multifocal leukoencephaolopathy),the result of JC virus infection, is a disastrous side effect.The decision to use this drug has to be very cautiously assessed by the MS patient &amp; his doctor &amp; administered through a restricted program. Risk/benefit analysis is complicated &amp; challenging.

Question 10

what are the current pml figures while taking tyasbri? how much at risk am i at if i have a negative jcv test? and if for some reason my jcv changes..

Accepted Answer

Bad risk: The jcv test is not very definitive.  Tysabri (natalizumab) lowers immune response and can cause activation of latent virus agents and prions.  The risk is significant regardless of the jcv status.

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Doctor answers about:

Medicine for pml

A member asked:

Is it possible that or does the drug methetrexate cause progressive multifocal leukoencephalopathy (pml)?

A member asked:

How can we detect pml?

A member asked:

What are the tests for pml?

A member asked:

Is there a gentle way to treat pml?

A member asked:

What are the symptoms associated with pml?

A member asked:

How do we prevent pml?

A member asked:

How does pml affect people with hiv?

A member asked:

Can you please give me more information on the jc virus and pml?

A member asked:

Does the benefit of tysabri (natalizumab) outweigh the risk of pml ?

A member asked:

What are the current pml figures while taking tyasbri? how much at risk am i at if i have a negative jcv test? and if for some reason my jcv changes..

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