The national incidence of PML in Sweden, 1988-2013
| Autor: | Lou Brundin, Scott Montgomery, Sarah Burkill, Tomas Olsson, Michael Fored, Shahram Bahmanyar, Camilla Byström, Ellen Iacobaeus, Ramil Hakim |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Neurology Patient characteristics Article Statistics Nonparametric 03 medical and health sciences 0302 clinical medicine medicine Humans Patient register 030212 general & internal medicine Longitudinal Studies Medical diagnosis Aged Sweden business.industry Medical record Progressive multifocal leukoencephalopathy Incidence (epidemiology) Incidence Leukoencephalopathy Progressive Multifocal Awareness Middle Aged medicine.disease JC Virus Female Neurology (clinical) business Tomography X-Ray Computed 030217 neurology & neurosurgery Immunosuppressive Agents |
| Zdroj: | Neurology |
| ISSN: | 1526-632X |
| Popis: | ObjectiveTo investigate the incidence of progressive multifocal leukoencephalopathy (PML) and patient characteristics in Sweden between 1988 and 2013.MethodsAll PML diagnoses in Sweden between 1988 and 2013 were identified in the National Patient Register. Information to validate the diagnosis and patient characteristics was obtained from medical records.ResultsMedical record review classified 108 out of 250 patients (43%) as definite (n = 84), probable (n = 4), or possible (n = 20) PML according to diagnostic criteria. Accurate diagnoses were more common in records obtained from neurology departments (82% of patients seen in neurology departments) compared with other departments (31%) (p < 0.001). The incidence of PML increased from a largely stable level at 0.026 (95% confidence interval [CI] 0.021–0.031) per 100,000 individuals per year during 1988–2010 to 0.11 (95% CI 083–0.137) during 2011–2013, during which time there was a notable increase (p < 0.001). Hematologic malignancies (n = 34), HIV/AIDS (n = 33), and autoimmune disease (n = 23) were the most common underlying diseases. Treatment with a monoclonal antibody prior to PML diagnosis was identified in 26 patients.ConclusionAn increased incidence of PML in Sweden was observed and coincided with the prior use of monoclonal antibody treatment. The high level of misdiagnosis emphasizes the importance of immediate contact with a neurology center upon suspicion of PML. |
| Databáze: | OpenAIRE |
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