Table 2.
Characteristic | Case 1 | Case 2 |
---|---|---|
Age, years | 70 | 62 |
Sex | F | M |
Country | Germany | Denmark |
Date PML confirmed | July 2012 | Sept. 2013 |
Duration of GPA, years | Not specified | 8 |
Relevant medical history | Immunoglobulin deficiency, breast cancer, diabetes mellitus, arterial hypertension, and chronic stage III renal insufficiency | None reported |
Prior treatments | CYC, epirubicin, 5-FU, prednisolone, and MTX | CYC, azathioprine, and high-dose glucocorticoids |
Concomitant drug | Azathioprine | None reported |
Rituximab treatment | Aug. 2011–March 2012 for GPA; no. of courses not specified | 2011–Mar 2013 occasionally as needed for GPA; no. of courses not specified |
Latency distribution (time from first rituximab infusion to PML diagnosis) | ≈ 11 months from first dose and ≈ 4 months from last dose, symptoms prior to the start of rituximab | ≈ 2 years from first dose and ≈ 6 months from the last dose |
PML treatment | Immune apheresis to eliminate residual rituximab, cidofovir, mefloquine, and mirtazapine | Mefloquine, mirtazapine, and cytarabine |
Outcome | ≈ 1 year after PML diagnosis, the patient’s condition had improved; however, she continued to experience cognitive deficits and JCV was still detected in her CSF | ≈ 3 months after PML diagnosis, the patient’s condition had improved |
5-FU, fluorouracil; CSF, cerebrospinal fluid; CYC, cyclophosphamide; F, female; GPA, granulomatosis with polyangiitis; JCV, John Cunningham polyomavirus; M, male; MTX, methotrexate; PML, progressive multifocal leukoencephalopathy