title: Progressive multifocal leukoencephalopathy after orthotopic liver transplantation.
abstract: Six weeks after liver transplantation, a 51-year-old man developed a slowly progressive hemiparesis with deteriorating mental status and seizures. Successive computed tomography (CT) scans of the brain revealed unilateral nonenhancing white matter lucencies that gradually coalesced and progressed to both hemispheres. Brain biopsy results were consistent with progressive multifocal leukoencephalopathy (PML). We believe this is the first antemortem description of PML after liver transplantation. Herein, we describe the case and review the literature on PML after solid organ transplantation. Early recognition of this central nervous system disease may be important with new advances in therapy of this viral infection of the immunocompromised patient.
authors.affiliation: Department of Neurology, Mount Sinai Medical Center, New York, NY 10029, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Bronster
authors.forename: M W
authors.initials: MW
authors.lastname: Lidov
authors.forename: D
authors.initials: D
authors.lastname: Wolfe
authors.forename: M E
authors.initials: ME
authors.lastname: Schwartz
authors.forename: C M
authors.initials: CM
authors.lastname: Miller
mesh_terms: D001706:Biopsy; D017809:Fatal Outcome; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007577:JC Virus; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000821:virology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents