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This is my first post and I don't really have a clue what I am doing! I came across this "lead-in" article on the "news for the day", i.e., current, New England Journal website. It costs $29.95 to read the entire article and I really don't want to make the investment. Perhaps some of you know what this means:

Progressive Multifocal Leukoencephalopathy, Natalizumab, and Multiple Sclerosis

To the Editor: According to the established definition of multiple sclerosis, the condition in the patient described by Kleinschmidt-DeMasters and Tyler (July 28 issue) should not have been diagnosed as multiple sclerosis. Apart from the unusual clinical findings, no oligoclonal bands were detected in two separate examinations of the cerebrospinal fluid, and repeated magnetic resonance imaging (MRI) scans obtained over the course of several years showed new and enlarging, but never enhancing, lesions. The most convincing argument against a diagnosis of multiple sclerosis is the neuropathology: no lesions that are characteristic for multiple sclerosis were detected. The patient . . . [Full Text of this Article]

Are they saying that this patient who took Natalizumab and developed PML didn't have MS?????? Any info or thoughts?

Chris, I quickly browsed these articles... don't quote me on this as I do't have them in front of me, but I believe that they make a very interesting assertion that two of the 3 PML patients did not have the typical markers for MS, and thus there is a possibility (emphasis) that what they had was either some demyelinating condition other than MS -or- that PML itself can start in relapsing-remitting form and mimic MS.

Interestingly enough, the original study authors then wrote back and defended the classification of these patients as indeed being MS'ers.

Fascinating point-counterpoint. We hope to be able to cover this soon in an expanded article.

Chris55 wrote:It costs $29.95 to read the entire article and I really don't want to make the investment.

If you have a university in your town or near you, then you should be able to access the full article from their library. Obtaining the article should only cost you the amount for the photocopying/printing.

NHE

I did not mention--and I am sure you all know--that Biogen asked the New England Journal to review the first Tysabri-PML death case. I am thinking this was their finding--that this patient did not have MS. It would be logical that if a patient was treated with an immune suppressing drug and the patient did not have an immune suppressing disease, PML could be an end result.

I must admit I see many "red flags" with Tysabri for a multitude of reasons. However, I am in an enviable position right now in that my daughter's MS is supposedly very mild and I can afford to be more selective in my thinking. My heart truly goes out to all who held this drug up as the ultimate miracle! I can identify. I read, research and pray constantly that something will surface for my beautiful daughter and all who are afflicted with this hideous disease. Thanks to all who replied.