Favourable outcome of progressive multifocal leucoencephalopathy in two patients with dermatomyositis.
Progressive multifocal leucoencephalopathy (PML), a demyelinating disease caused by the JC virus (JCV), occurs in immunosuppressed patients and carries a poor prognosis. A favourable outcome is reported in two patients with PML and dermatomyositis. Immunosuppressive drugs were stopped in patient 1 but could only be partially tapered in patient 2. The JCV-specific CD8+ T cell response was strong in patient 1 and weak in patient 2. Both were treated with cytosine-arabinoside, and patient 2 was also treated with mirtazapine, a 5HT2A receptor antagonist. Combination of these drugs might be helpful to treat HIV-negative patients with PML.
Vulliemoz
S
S
Service de Neurologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
Lurati-Ruiz
F
F
Borruat
F-X
FX
Delavelle
J
J
Koralnik
I J
IJ
Kuntzer
T
T
Bogousslavsky
J
J
Picard
F
F
Landis
T
T
Du Pasquier
R A
RA
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D003882:Dermatomyositis / Q000150:complications*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D016896:Treatment Outcome
D000317:Adrenergic alpha-Antagonists; D007166:Immunosuppressive Agents; D003561:Cytarabine; D008803:Mianserin; D000078785:Mirtazapine