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Progressive multifocal leukoencephalopathy in autoimmune disorders
  1. D Focosi1,
  2. F Maggi2,
  3. L Ceccherini-Nelli2,
  4. S Marchi3,
  5. M Petrine1
  1. 1
    Division of Hematology, University of Pisa, Italy
  2. 2
    Virology Section and Retrovirus Centre, University of Pisa, Italy
  3. 3
    Division of Gastroenterology, University of Pisa, Italy
  1. Dr D Focosi, Division of Hematology, University of Pisa, Via Roma 56, 56123 Pisa, Italy; dfocosi{at}

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We read with interest the recent article by Verbeeck et al (Gut 2008;57:1393–7) on JC viral loads as a predictor of progressive multifocal leukoencephalopathy (PML) in patients with Crohn’s disease, but we have found some misconceptions.

The authors wrongly state that “Although PML has been associated with immunosuppression as a consequence of organ transplantation and haematological malignancies, it has not been associated with immune-mediated disorders such as MS, Crohn’s disease or rheumatoid arthritis despite the immunosuppressive therapy used to treat their illnesses”. Many case reports exist for PML in such cohorts17 and PML is likely to arise in …

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  • Competing interests: None.