A 27-Year-Old Woman with Multiple Sclerosis Comes to the Physician

question 15

Multiple Choice

A 27-year-old woman with multiple sclerosis comes to the physician because of right arm numbness and mild balance problems for the past one month.  She was diagnosed with multiple sclerosis one year ago after presenting with partial right-sided vision loss and finger tingling.  She was treated with corticosteroids for two weeks and had improvement of her symptoms.  She has been treated with glatiramer acetate since then.  She developed a recurrence of right-sided hand numbness 1 month ago that progressed to right arm numbness and left leg weakness.  Her past medical history is otherwise unremarkable.
Routine laboratory tests, including complete blood count and comprehensive metabolic panel, are unremarkable.  Repeat MRI of the brain shows white matter changes that appear to be worse compared to the study one year ago.  She is being considered for a switch to natalizumab therapy due to progressive disease.
Which of the following antibody titers would be most helpful in managing this patient?

• A)BK virus
• B)Epstein-Barr virus
• C)Herpes simplex 1
• D)JC virus
• E)Varicella zoster virus

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