{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:31:04Z","timestamp":1782311464389,"version":"3.54.5"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>We report the first case of findings suggestive of progressive multifocal leukoencephalopathy and immune restitution syndrome (PML-IRIS) in a patient with multiple sclerosis receiving ozanimod preceded by an unexpected increase in the serum neurofilament light-chain (sNfL) levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 57-year-old-woman treated with ozanimod for the last 8 years presented, during surveillance MRI, with findings compatible with PML-IRIS. Overt clinical symptoms were absent. sNfL levels increased 4 months earlier and peaked at presentation. Lymphocyte count reached nadir of 330\/mL at 8 months earlier.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The case illustrates the utility of sNfL levels for PML surveillance in patients receiving immunosuppressors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1465678","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T10:03:12Z","timestamp":1729591392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Elevation of serum neurofilament light-chain levels disclose possible occult progressive multifocal leukoencephalopathy and immune reconstitution syndrome in a patient receiving ozanimod: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Carlos","family":"Quintanilla-Bord\u00e1s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gorriz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cubas-N\u00fa\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica","family":"Castillo-Villalba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Carreres-Polo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonaventura","family":"Casanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Carlos","family":"P\u00e9rez-Miralles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25437","article-title":"Serum neurofilaments increase at progressive multifocal leukoencephalopathy onset in natalizumab-treated multiple sclerosis patients","volume":"85","author":"Dalla Costa","year":"2019","journal-title":"Ann Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10910-1","article-title":"Progressive multifocal leukoencephalopathy and sphingosine 1-phosphate receptor modulators used in multiple sclerosis: an updated review of literature","volume":"269","author":"Sriwastava","year":"2022","journal-title":"J Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313772","article-title":"MRI criteria differentiating asymptomatic PML from new MS lesions 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Neuroinflamm"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828c2fa1","article-title":"PML diagnostic criteria","volume":"80","author":"Berger","year":"2013","journal-title":"Neurology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.nerep.2022.100067","article-title":"Diagnostic challenges of fingolimod-associated PML-IRIS","volume":"2","author":"Cuello-Oderiz","year":"2022","journal-title":"Neuroimmunol Rep"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.nerep.2022.100115","article-title":"SARS-CoV-2 induced lymphopenia leading to novel PML infection","volume":"2","author":"Murray","year":"2022","journal-title":"Neuroimmunol Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijid.2023.09.020","article-title":"Progressive multifocal leukoencephalopathy triggered by COVID-19 in a previously asymptomatic person living with undiagnosed HIV 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