Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Progressive multifocal leukoencephalopathy in a patient without apparent immunosuppression | Vaklavas et al. Virology Journal 2010 7 256 http content 7 1 256 VIROLOGY JOURNAL CASE REPORT Open Access Progressive multifocal leukoencephalopathy in a patient without apparent immunosuppression 1 23 1 4 Christos Vaklavas Elsa P Sotelo-Rafiq Jordan Lovy Miguel A Escobar Apostolia M Tsimberidou Abstract An 80-year-old man with no history of an immune-compromising disorder was diagnosed with progressive multifocal leukoencephalopathy PML . He presented with dysphagia and left-sided weakness magnetic resonance imaging demonstrated marked signal abnormality in the subcortical white matter of the left frontal lobe and in the posterior limb of the right internal capsule. Polymerase chain reaction PCR analysis of the cerebrospinal fluid CSF was negative for John Cunningham JC virus. On brain biopsy foamy macrophages infiltrating the white matter were identified staining positive for anti-simian virus 40 antibodies. Postoperatively PCR for JC viral DNA in the CSF was positive establishing the diagnosis of PML. Extensive investigation for an occult immunocompromising disorder was negative. The patient s neurologic deficits rapidly increased throughout his hospital stay and he died months after his diagnosis. Introduction Progressive multifocal leukoencephalopathy PML is a rapidly advancing demyelinating disorder of the central nervous system almost exclusively encountered in immunocompromised individuals 1 . It is caused by reactivation of the John Cunningham virus JCV under conditions of cellular immunocompromise such as those encountered in patients with acquired immunodeficiency syndrome AIDS patients with hematologic and solid organ malignancies receiving chemotherapy and transplant recipients under immunosuppression 2 . The interest in this disease has recently increased because of its association with nata-lizumab a monoclonal antibody directed against a4 integ-rins that is used to treat Crohn s disease 3 and multiple sclerosis 4 . Here we .
