Progressive multifocal leukoencephalopathy in a haploidentical stem cell transplant recipient: a clinical, neuroradiological and virological response after treatment with risperidone.
JC virus (JCV) is a double-stranded DNA virus belonging to family Polyomaviridae. It causes progressive multifocal leukoencephalopathy (PML), mainly in immunosuppressed people. JCV had been shown to require the serotonin 2A receptor for host cell entry. We report a case of clinical, neuroradiological and virological response of biopsy-proven PML in a 33-year-old comatose woman after treatment with the anti-psychotic drug risperidone. Since risperidone is the tightest binding of current drugs to this receptor we think this may have blocked JCV entry in our patient, allowing her immune recovery and viral clearance.
Focosi
Daniele
D
Division of Hematology, Azienda Ospedaliera Universitaria Santa Chiara, via Roma 56, 56100 Pisa, Italy. focosi@icgeb.org
Fazzi
Rita
R
Montanaro
Domenico
D
Emdin
Michele
M
Petrini
Mario
M
D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007577:JC Virus / Q000187:drug effects*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology*; D008279:Magnetic Resonance Imaging; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy; D011859:Radiography; D018967:Risperidone / Q000494:pharmacology / Q000627:therapeutic use*; D033581:Stem Cell Transplantation
D000998:Antiviral Agents; D018967:Risperidone