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In a recent case report, Bergmans et al. (2025) highlighted the challenges in diagnosing progressive multifocal leukoencephalopathy (PML) in a patient with rheumatoid arthritis (RA) undergoing treatment with rituximab, a type of immunosuppressant. PML is a serious condition affecting the brain, caused by the John Cunningham polyomavirus, and is particularly risky for those with weakened immune systems. The case underscores the importance of early detection of PML, which is critical for patient survival.
The report also reviews existing literature on PML in RA patients treated with biological therapies, emphasizing the diagnostic hurdles and frequent delays. This review aims to increase awareness among doctors who prescribe immunosuppressive treatments for RA, as recognizing the signs of PML early can be life-saving.
