Successful outcome of progressive multifocal leukoencephalopathy in a renal transplant patient.
We report the case of a 47-year-old man who developed progressive multifocal leukoencephalopathy (PML) after receiving immuno-suppressive therapy for renal transplantation. The patient presented with a focal seizure and cognitive changes 5 months post-transplantation. He was found to have enhancing lesions in the parietal lobe and typical findings of PML in a brain biopsy. Immunosuppression was discontinued and the neurological symptoms gradually resolved over a period of 4 weeks. The patient is free of any neurological symptoms 36 months after the diagnosis of PML and imaging studies demonstrate resolution of the PML lesions. The patient returned to hemodialysis 3 months after immunosuppression was discontinued. We also present a review of the literature on PML in renal transplant recipients.
Crowder
Clinton D
CD
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Gyure
Kymberly A
KA
Drachenberg
Cinthia B
CB
Werner
Joseph
J
Morales
Robert E
RE
Hirsch
Hans H
HH
Ramos
Emilio
E
D001706:Biopsy; D001921:Brain / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007577:JC Virus / Q000378:metabolism; D016030:Kidney Transplantation / Q000009:adverse effects*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009394:Nephritis, Hereditary / Q000150:complications; D009836:Oligodendroglia / Q000378:metabolism; D011183:Postoperative Complications; D011379:Prognosis
D007166:Immunosuppressive Agents