title: Inflammatory progressive multifocal leukoencephalopathy in human immunodeficiency virus-negative patients.
abstract: OBJECTIVE
  Inflammatory progressive multifocal leukoencephalopathy (iPML) with enhancing magnetic resonance imaging (MRI) lesions and leukocyte infiltration occurs in human immunodeficiency virus (HIV)-infected individuals after highly active antiretroviral therapy (HAART) treatment. MRI diagnostic criteria for PML suggest that iPML does not occur in HIV-negative individuals.
  
  
  METHODS
  We studied pathologically proved PML (12 by biopsy, 9 with MRI, 32 at autopsy).
  
  
  RESULTS
  HIV-negative (2/5) and -positive (2/4) PML patients had enhancing MRI lesions, correlated with CD3(+) lymphocyte infiltration. Inflammatory infiltrates occurred in the majority of HIV-negative (7/8) and HIV-positive/HAART (17/20) cases (p > 0.2), but in only 2 of 16 HIV-positive/non-HAART cases (p < 0.001).
  
  
  CONCLUSIONS
  iPML showed radiographic and pathological similarity in HIV-positive/HAART and HIV-negative patients. HIV-negative iPML necessitates further consideration of MRI criteria for PML.
authors.affiliation: Department of Neurology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. huangd2@ccf.org
authors.forename: DeRen
authors.initials: D
authors.lastname: Huang
authors.forename: Michael
authors.initials: M
authors.lastname: Cossoy
authors.forename: Meizhang
authors.initials: M
authors.lastname: Li
authors.forename: Dean
authors.initials: D
authors.lastname: Choi
authors.forename: Alan
authors.initials: A
authors.lastname: Taege
authors.forename: Susan M
authors.initials: SM
authors.lastname: Staugaitis
authors.forename: Susan
authors.initials: S
authors.lastname: Rehm
authors.forename: Richard M
authors.initials: RM
authors.lastname: Ransohoff
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D001921:Brain / Q000473:pathology / Q000821:virology; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000276:immunology / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged