{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:26:41Z","timestamp":1787300801601,"version":"build-2736575974"},"reference-count":11,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:p>\n                    Natalizumab is a highly effective therapy but may impair central nervous system (CNS) immune surveillance, leading to rare opportunistic infections. We report a fatal case of cerebral toxoplasmosis under natalizumab. A 61-year-old man with stable multiple sclerosis (MS) developed acute hemiparesis on natalizumab therapy. Magnetic resonance imaging (MRI) showed multiple ring-enhancing lesions. Brain biopsy and polymerase chain reaction (PCR) confirmed reactivated\n                    <jats:italic toggle=\"yes\">Toxoplasma gondii<\/jats:italic>\n                    . A low-risk IgG \u03ba monoclonal gammopathy of undetermined significance (MGUS) was identified. Despite antiparasitic therapy, the patient developed coma and died. Natalizumab-induced CNS immune compartmentalization, combined with subtle MGUS-related immune dysfunction and immunosenescence, may have facilitated intracerebral reactivation. Vigilance for opportunistic infections may be warranted in older patients with hematologic comorbidities receiving natalizumab.\n                  <\/jats:p>","DOI":"10.1177\/13524585261477217","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:49:26Z","timestamp":1787028566000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Fatal cerebral toxoplasmosis in a patient with multiple sclerosis treated with natalizumab"],"prefix":"10.1177","author":[{"given":"Elvis","family":"Wend-Lamita Konseiga","sequence":"first","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-496X","authenticated-orcid":false,"given":"Adil","family":"Maarouf","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3119-8203","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Bouti\u00e8re","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Demorti\u00e8re","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Rico","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-7657","authenticated-orcid":false,"given":"Bertrand","family":"Audoin","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Pelletier","sequence":"additional","affiliation":[{"name":"P\u00f4le de Neurosciences Cliniques, Service de Neurologie, Assistance Publique \u2013 H\u00f4pitaux de Marseille, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-322326"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00115-19"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2025.106416"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2017.05.004"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181bd114f"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010691"},{"issue":"1","key":"e_1_3_2_8_2","first-page":"163","article-title":"Risk of infections in multiple myeloma. A population-based study on 8,672 multiple myeloma patients diagnosed 2008-2021 from the Swedish Myeloma Registry","volume":"110","author":"Blimark CH","year":"2025","unstructured":"Blimark CH, Carlson K, Day C, et al. Risk of infections in multiple myeloma. A population-based study on 8,672 multiple myeloma patients diagnosed 2008-2021 from the Swedish Myeloma Registry. Haematologica 2025; 110(1): 163\u2013172.","journal-title":"Haematologica"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00580-7"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20112822"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1709974"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01506-9"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261477217","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585261477217","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261477217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:12:48Z","timestamp":1787299968000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585261477217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":11,"alternative-id":["10.1177\/13524585261477217"],"URL":"https:\/\/doi.org\/10.1177\/13524585261477217","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"13524585261477217"}}