Progressive multifocal leukoencephalopathy in an AIDS patient.
Progressive multifocal leukoencephalopathy (PML) is a demyelinating brain disease caused by Jamestown Canyon virus (JCV). This disease is an important cause of morbidity and mortality in acquired immunodeficiency syndrome (AIDS) patients. We report a 34-year-old man infected with HIV-1 who presented with frequent general tonic clonic seizure and left side weakness for 2 months. Clinical features and magnetic resonance imaging (MRI) findings with hyperintensity on T2-weighted imaging and low density on T2 fluid attenuated inversion recovery involving multiple white matter were compatible with PML. He died of sepsis 2 months after diagnosis. Autopsy demonstrated progressive multifocal leukoencephalopathy according to characteristic histopathologic picture with multifocal demyelination, bizarre astrocytes formation and basophilic intranuclear inclusion bodies in the oligodendrocytes. JCV genome was demonstrated in the nucleus of oligodendrocytes using in situ hybridization. In conclusion, in AIDS patients with neurologic signs and typical MRI findings who present with multifocal demyelination lesions, PML should be diagnosed clinically.
Lee
Ming-Hsing
MH
Department of Pathology, Tzu-Chi University and Buddhist Tzu-Chi General Hospital, Hualien, Taiwan.
Chen
Yan-Zhong
YZ
Wang
Lih-Shinn
LS
Yen
Pao-Sheng
PS
Hsu
Yung-Hsiang
YH
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis*; D000328:Adult; D001921:Brain / Q000473:pathology; D015497:HIV-1; D006801:Humans; D007577:JC Virus; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male