A 48-year-old male diagnosed with RRMS since 19 years of age.
Therapeutic failure of interferon-beta was decided to start natalizumab, resulting in radiological stabilization and absence of sprouts during treatment (EDSS 0.5).
The drug was suspended at 4.5 years due to positive serology CJV, and two months after its discontinuation a new demyelinating plaque appeared in the left parietal portion of the semioval center on CMR.
After resolution of the sprout and a six-month PL with respect to natalizumab in treatment with megadoses of corticosteroids and glatiramer acetate, it was decided to initiate fingmod (EDSS 4,5).
One year after that, new demyelinating plaques adjacent to the body of the left ventricular system and a new lesion in the medullary segment C7 appeared, leading to two successive sprouts.
Treatment was discontinued due to reactivation of the disease (EDSS 5).
In addition, the patient presented gait instability during this treatment, requiring three boluses of corticosteroids.
The patient developed lymphopenia during the whole treatment (500-1000 cells/mmc), which did not lead to its interruption.
